title: Occupational Therapy and Physiotherapy in Acute Stroke: Do Rural Patients Receive Less Therapy?
abstract: Objective. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals.Design. Retrospective case-control study of health data in patients ≤10 days after stroke.Setting. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital.Participants. Acute stroke patients admitted in one health district.Main Outcome Measures. Frequency and duration of face-to-face and indirect therapy sessions.Results. Rural hospitals admitted 363 patients and metropolitan hospital admitted 378 patients. Mean age was 73 years. Those in rural hospitals received more face-to-face (p> 0.0014) and indirect (p= 0.001) occupational therapy when compared to those in the metropolitan hospital. Face-to-face sessions lasted longer (p= 0.001). Patients admitted to the metropolitan hospital received more face-to-face (p> 0.000) and indirect (p> 0.000) physiotherapy when compared to those admitted to rural hospitals. Face-to-face sessions were shorter (p> 0.000). Almost all were seen within 24 hours of referral.Conclusions. Acute stroke patients in Australian rural hospital may receive more occupational therapy and less physiotherapy than those in metropolitan hospitals. The dose of therapy was lower than recommended, and the referral process may unnecessarily delay the time from admission to a patient's first therapy session.
authors.affiliation: Occupational Therapy, School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: Josie
authors.identifier: 0000-0001-9672-3788
authors.initials: J
authors.lastname: Merchant
authors.affiliation: Neurology Department, Hunter New England Area Health Service, New Lambton Heights, NSW 2305, Australia.
authors.forename: Gemma
authors.identifier: 0000-0003-4299-6216
authors.initials: G
authors.lastname: Kitsos
authors.affiliation: Occupational Therapy, School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Ashby
authors.affiliation: Hunter New England Area Health Service, New Lambton Heights, NSW 2305, Australia.
authors.forename: Alex
authors.identifier: 0000-0003-4319-1559
authors.initials: A
authors.lastname: Kitsos
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: Isobel J
authors.identifier: 0000-0003-0208-305X
authors.initials: IJ
authors.lastname: Hubbard