Different strokes: need for help among stroke-affected persons in British Columbia.
BACKGROUND
Cerebrovascular disease (CD) is a leading cause of disability and death in British Columbia, as in much of the developed world. Provision of care for stroke-affected persons depends upon accurate estimates of prevalence, but also on a clearer understanding of the specific characteristics and needs of this population.


METHODS
Data are drawn from the Canadian Community Health Survey, Cycle 1.1, 2000 - 2001. Bivariate analysis examines older populations age 55+ living in BC to determine how stroke-affected persons differ from non-stroke-affected persons according to sociodemographic factors, health, co-morbid conditions, need for help, and service use. Multivariate logistic regression was used to assess the impact of stroke status on need for help with regular and instrumental activities of daily living.


RESULTS
Risk of stroke rises every decade after age 55. The prevalence of CD in British Columbia is 3.7% among those age 55+ and 5.2% among those age 65+. Stroke survivors use more acute care services (i.e., they spend more nights in hospital and consult physicians more often on an annual basis). Being older and female, as well as having lower income and poor health are characteristics of stroke survivors. Even after controlling for these variables, the odds of needing help with regular tasks of daily living are still higher for stroke-affected persons because of the high level of disability associated with stroke.


CONCLUSIONS
Ultimately, while it is appropriate to target acute care resources to treat stroke and to minimize negative stroke outcomes, these data support the need to develop a clearer understanding of the needs and service utilization patterns of community-dwelling stroke survivors to ensure access to a full continuum of care.
Cloutier-Fisher
Denise S
DS
Department of Geography/Centre on Aging, University of Victoria, Victoria, BC. dcfisher@uvic.ca
D000203:Activities of Daily Living; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006306:Health Surveys; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology*; D000071939:Stroke Rehabilitation; D017741:Survivors / Q000706:statistics & numerical data*; D014600:Utilization Review