title: Differences between younger and older individuals in their use of care and rehabilitation but not in self-perceived global recovery 1year after stroke.
abstract: BACKGROUND
  Although priorities in Swedish stroke care should be based on the ethical principles of equal care and greatest support to those in greatest need, being of working age (younger) or retired (older) might influence expectations on recovery and the provision of care and rehabilitation.
  
  
  METHODS
  Information regarding the use of care and rehabilitation during the 1st year after stroke was retrieved from the Stockholm County Council database and the medical data was taken from the medical records. The Barthel Index was used for self-ratings of dependence pre-stroke, and the Stroke Impact Scale was used to assess self-perceived disability and a global rating of recovery at 12 months. One hundred and ninety-two individuals were included.
  
  
  RESULTS
  Results showed that the younger group received more care and rehabilitation than the older group. In the older group, comorbid conditions and pre-stroke dependence, estimated in accordance with the Barthel Index, were more common. The older group reported larger impact on self-perceived disability regarding strength, mobility, self-care and domestic life, while self-perceived global recovery did not differ between the groups.
  
  
  CONCLUSIONS
  Younger individuals received more care and rehabilitation, which indicates structural inequality in the provision of health care resources. However, as no difference in self-perceived global recovery was found between the groups; the disparity in the provision of health care may also be a consequence of greatest support being given to those in greatest need. By demonstrating the necessity of involving self-rated assessments of stroke impact at different points in time and in different age groups, the results of this study add to previous knowledge of age-related differences in the provision of health care and stroke outcome. Furthermore, this suggests a way to approach evaluation of equality in the provision of health care.
authors: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. susanne.palmcrantz@ki.se
authors: Susanne
authors: S
authors: Palmcrantz
authors: Palmcrantz
authors: P
authors: Susanne
authors: Lotta Widén
authors: LW
authors: Holmqvist
authors: Widén Holmqvist
authors: WH
authors: Lotta
authors: Disa K
authors: DK
authors: Sommerfeld
authors: Sommerfeld Disa
authors: SD
authors: K
authors: Malin
authors: M
authors: Tistad
authors: Tistad
authors: T
authors: Malin
authors: Charlotte
authors: C
authors: Ytterberg
authors: Ytterberg
authors: Y
authors: Charlotte
authors: Lena
authors: L
authors: von Koch
authors: von Koch
authors: vK
authors: Lena
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D012649:Self Concept; D018709:Statistics, Nonparametric; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D013548:Sweden; D055815:Young Adult