title: Rehabilitation assessments for patients with stroke in Australian hospitals do not always reflect the patients' rehabilitation requirements.
abstract: OBJECTIVE
  To examine the frequency and factors associated with patients with stroke in Australian hospitals receiving documented rehabilitation assessments; to examine the criteria used when rehabilitation was not recommended; and to examine whether being assessed for rehabilitation affected access to rehabilitation.
  
  
  METHODS
  Retrospective medical record audit of patients with a diagnosis of stroke who were discharged consecutively between 2013 and 2014.
  
  
  METHODS
  Acute care public hospitals.
  
  
  METHODS
  Adults with stroke (N=333) receiving care in participating hospitals.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Documented assessment regarding patient suitability for rehabilitation during acute hospitalization.
  
  
  RESULTS
  Data from 292 patients were included for analysis (60% men; mean age, 72y). Of the patients, 42% were assessed for rehabilitation by a health professional providing care in the hospital, 43% were assessed for rehabilitation by a representative from a rehabilitation service, and 37% did not receive any documented rehabilitation assessment. In multivariable analysis, patients were significantly more likely to be assessed for rehabilitation if they lived in the community before their stroke, had moderate severity strokes, or received occupational therapy during hospital admission. Rehabilitation was not recommended in 9% of assessments despite the presence of stroke-related symptoms. Patients not assessed for rehabilitation were significantly less likely to access rehabilitation than patients who were assessed.
  
  
  CONCLUSIONS
  More than one third of patients were not assessed for rehabilitation. When assessed, rehabilitation was not consistently recommended for patients with stroke-related symptoms. This study highlights factors that increase the likelihood of being assessed for rehabilitation.
authors.affiliation: International Centre of Allied Health Evidence, University of South Australia, Adelaide, South Australia. Electronic address: Elizabeth.lynch@mymail.unisa.edu.au.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lynch
authors.affiliation: International Centre of Allied Health Evidence, University of South Australia, Adelaide, South Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Luker
authors.affiliation: Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria; Stroke and Ageing Research Group, Monash University, Melbourne, Victoria, Australia.
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Cadilhac
authors.affiliation: International Centre of Allied Health Evidence, University of South Australia, Adelaide, South Australia.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hillier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D004185:Disability Evaluation; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D026741:Physical Therapy Modalities; D012111:Residence Characteristics; D012189:Retrospective Studies; D000071939:Stroke Rehabilitation; D015599:Trauma Severity Indices
keywords: Australia; Needs assessment; Rehabilitation; Stroke