Post-acute Neurorehabilitation for Stroke as a Community Effort
Adonay Castillo1, Erin Feinstein1 1Rutgers New Jersey Medical School
Objective:
To review and analyze inpatient rehabilitation alternatives for uninsured, low-income, undocumented people and migrants stroke survivors in New Jersey.
Background:
Rehabilitation outcomes post stroke are greatly influenced by access to community care rehabilitation and social services, which are determined by the patient’s medical insurance coverage. Post-Acute rehabilitation typically consists of inpatient rehabilitation facility, skilled nursing facilities, and home health aide.
Design/Methods:
Conducted a literature review using Embase, JStor, PubMed, Medline
Results:
Disparities over use of post-acute rehabilitation services and their respective impact over functional outcomes have been well documented to affect uninsured and low-income stroke survivors. These include delay in initiation of rehabilitation and increased length of hospital stay secondary to inability to transfer to a rehabilitation facility due to the patients’ lack of respective qualification to such services. Family-directed training has been shown to enhance family support, which leads to improved functional outcomes. Research regarding undocumented people and migrant on this issue is limited and merits deeper inquiry.
Conclusions:
To best support post-stroke access to rehabilitation services and provide alternatives for low-income, uninsured, undocumented migrant individuals in New Jersey, a multidisciplinary approach that targets early recognition of risk factors and extends into continuity of care post inpatient needs is recommended. Further research is also required to ascertain the feasibility of combined alternatives such as home-based rehabilitation involving social support building with formal family/caregiver training, community-based exercise programs, and/or telerehabilitation to increase functional improvement post stroke.