Outcomes of intermediate care for post-stroke patients through the Outreach Rehabilitation Program at Lampang Hospital
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Abstract
BACKGROUND: The Outreach Rehabilitation Program of Lampang Hospital has been implemented for post-stroke patients who are unable to access hospital-based rehabilitation services. However, its functional outcomes and effectiveness after program completion have not been systematically evaluated.
OBJECTIVE: To evaluate the functional outcomes and effectiveness of Outreach Rehabilitation Program on changes in activities of daily living (ADL) from program initiation to completion among post-stroke patients during the intermediate care phase.
METHODS: A retrospective cohort study was conducted using medical records of post-stroke patients who participated in the Outreach Rehabilitation Program between September 2023 and September 2024. Fifty-nine patients who completed the 6-month program were included. Functional independence in ADL was assessed using the Barthel Index at initiation and at program completion. Changes in Barthel Index scores were analyzed using paired t-tests, and subgroup comparisons were performed using one-way analysis of variance (ANOVA).
RESULTS: Most participants were older adults (84.8%), with a mean age of 68.8 ± 11.6 years. The most prevalent post-stroke impairment was communication disorder (17%). Shoulder subluxation was the most common complication (35.6%). There was a statistically significant improvement in mean Barthel Index scores from initiation to program completion (p<0.001), with a mean increase of 5.3 ± 4.2 points. Patients with post-stroke complications demonstrated significantly smaller improvements in Barthel Index scores compared with those without, with a 2.61-point lower mean improvement (p=0.017).
CONCLUSIONS AND RECOMMENDATIONS: The Outreach Rehabilitation Program significantly improved functional independence in ADL among post-stroke patients during the intermediate care. Future studies should incorporate patient-reported outcomes, including health-related quality of life, psychological well-being, stress among patients and caregivers, and economic evaluations comparing service costs with institutional reimbursement models.
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