Barriers for Utilization of Institutional Rehabilitation Services by Stroke Patients in a Developing Country (4080)

Objective: This study aims to observe the pattern of utilization and barriers for institutional rehabilitation services by stroke patients with disability in a developing country. Background: Rehabilitation in patients with stroke aims to maximize functional independence, thereby, enhancing the quality of life and better community participation. This assumes importance as incidence and prevalence of stroke is increasing among young people. Utilization of rehabilitation services is a significant issue in developing countries. Design/Methods: In this observational study done at a tertiary referral care center, data of 473 patients admitted to in-patient stroke ward from January 2019 to September 2019 was analyzed. Data collected included, demographics, socio-economics, length of stay in hospital, out-of-pocket expenditure for treatment, geographical distance from rehabilitation unit. Data on length of stay in intensive care unit was not included. Results: The mean age of the cohort was 58.95±14.83 (12–89) years with 175(36.9%) aged below 55 years. Mean constituted for 68.9% of the study population. The average length of stay in patient wards was 6.03±5.77 days. Institutional rehabilitation service were utilized by 61(12.9%) patients with average age of 44.83±12.71 years and among whom 43(70.5%) were men. Mean length of stay in rehabilitation was 7.72±4.53 years. The reported barriers for utilization were distance from service by 160(33.8%), lack of healthcare insurance 88(18.6%) and out-of-pocket unaffordability by 78(16.5%) patients. Conclusions: The main barrier for utilization of services was distance from rehabilitation units and lack of financial coverage/assistance for rehabilitation by healthcare insurance providers. A trend of higher utilization was observed in younger patients and those nearer to institute. Efforts should be made to improve physical and financial access to rehabilitation services. Disclosure: Dr. Vooturi has nothing to disclose. Dr. Yada has nothing to disclose. Dr. Kaul has nothing to disclose.