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From healthcare system to individuals through stroke rehabilitation pathways. Outcomes, information, and satisfaction along 12 months prospective cohort in Portugal

dc.contributor.authorBarbosa, Pedro Maciel
dc.contributor.authorMachado, João Firmino
dc.contributor.authorFerreira, Lara Noronha
dc.contributor.authorCruz, Vitor Tedim
dc.contributor.authorSzrek, Helena
dc.contributor.authorBarbosa, Pedro
dc.date.accessioned2026-07-14T09:56:46Z
dc.date.available2026-07-14T09:56:46Z
dc.date.issued2023-01-18
dc.description.abstractThe nature and quality of stroke survivor rehabilitation varies throughout Europe,including in Portugal, having not been widely monitored or benchmarked. This study analyses the stroke care pathway from three perspectives: healthcare system, process, and patient. The study uses data from a one-year single-center prospective cohort of first stroke patients, assessed at baseline, 3, 6, and 12 months. Care pathways and settings were described interms of organizational model, funding, patient involvement, frequency and intensity and multi-disciplinary team. Patient-level information and satisfaction were evaluated using a 10-point numeric rating scale. Kruskal – Wallis and post-hoc tests were used to compare EQ-5D-3 L, National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Barthel Index, Mini-Mental State Examination scores between pathways and settings. A total of 391 acute stroke patients, with a mean disability of 3.7 (mRS) and severity of 11.7(NIHSS) participated. Six pathways and eight settings were described. A lack of compliance between guidelines and care was identified. There were significant differences in the four outcomes between the six pathways (p-values 0.007 to 0.020) suggesting inefficiency and inequalities, with an inadequate level of information and patient satisfaction. After post-hoc analysis, pathways 1 and 2 showed highest outcomes (p-values 0.001 to 0.002). Within settings, short-term units showed high scores,followed by rehabilitation center, outpatient hospital, and community clinic (p-values 0.001 to 0.040).A multilevel characterization of the post-stroke rehabilitation pathway showed a more complete perspective on stroke management which may contribute to future rehabilitation and stroke policies.eng
dc.identifier.citationMaciel Barbosa, P., Firmino-Machado, J., Ferreira, L. N., Tedim Cruz, V., & Szrek, H. (2023). From healthcare system to individuals through stroke rehabilitation pathways. Outcomes, information, and satisfaction along 12 months prospective cohort in Portugal. Topics in Stroke Rehabilitation, 30(7), 727–737. https://doi.org/10.1080/10749357.2023.2165266
dc.identifier.doi10.1080/10749357.2023.2165266
dc.identifier.eissn1945-5119
dc.identifier.issn1074-9357
dc.identifier.urihttp://hdl.handle.net/10400.22/32583
dc.language.isoeng
dc.peerreviewedyes
dc.publisherTaylor &Francis
dc.relation.hasversionhttps://doi.org/10.1080/10749357.2023.2165266
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectStroke
dc.subjectPathway
dc.subjectRehabilitation
dc.subjectOutcomes
dc.subjectSatisfaction
dc.titleFrom healthcare system to individuals through stroke rehabilitation pathways. Outcomes, information, and satisfaction along 12 months prospective cohort in Portugaleng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.endPage737
oaire.citation.issue7
oaire.citation.startPage727
oaire.citation.titleTopics in Stroke Rehabilitation
oaire.citation.volume30
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameBarbosa
person.givenNamePedro
person.identifier.ciencia-id7211-01BC-964D
person.identifier.orcid0000-0003-4189-674X
relation.isAuthorOfPublication5bc4be6b-7ce7-4c0a-a4d4-7ac41319ca94
relation.isAuthorOfPublication.latestForDiscovery5bc4be6b-7ce7-4c0a-a4d4-7ac41319ca94

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