Rehabilitation utilisation up to 24 months after stroke: a register-based cohort study in southern Sweden

Knowledge about the quantity, delivery and setting of rehabilitation after stroke in clinical practice is sparse. We investigated the utilisation of rehabilitation services in a regional cohort up to 2 years after stroke.

Data on people living in ordinary housing in southern Sweden with a first-ever stroke during 2016-2017 were collected from the Swedish Stroke Registry and linked to healthcare data from regional and private primary care settings, inpatient and outpatient hospital care and general population registries up to 24 months after stroke onset. Rehabilitation consultations after discharge were analysed using descriptive statistics, categorised by setting and delivery and stratified by age, living situation and sex.

A total of 3034 people were included, who received more than 41,000 rehabilitation consultations over 24 months. During the first 3 months 42% received rehabilitation, as did 42% during months 4-12 and 32% during months 13-24. People under 65 years received rehabilitation more often than people aged 65-74, 75-84 or older than 84 years (57%, 44%, 36% and 19%, respectively) during the initial 3 months. These differences persisted at 4-12 and 13-24 months. Over 24 months, 40% of the consultations were delivered in primary care, 28% in specialised outpatient hospital care and 32% in specialised inpatient hospital care. Furthermore, 55%, 38% and 7% of all consultations were delivered by multi-professional teams, physiotherapists and occupational therapists.

Less than half of the participants after stroke utilised rehabilitation during the 2 years and the intensity, setting and delivery varied over time. Further studies are warranted to evaluate if the amount of rehabilitation matches individual needs after stroke.