First year post-stroke healthcare costs and fall-status among those discharged in the community

Introduction: Falls are common post-stroke events but their relationship with healthcare costs is unclear. The aim of this study was to examine the relationship between healthcare costs in the first year after stroke and falls among survivors discharged to the community. Patients and Methods: Survivors of acute stroke with planned home-discharges from five large hospitals in Ireland were recruited. Falls and healthcare utilisation data were recorded using inpatient records, monthly calendars and post-discharge interviews. Cost of stroke was estimated for each participant from hospital admission for one year. The association of fall-status with overall cost was tested with multivariable linear regression analysis adjusting for pre-stroke function, stroke severity, age and living situation. Results: 109 stroke survivors with complete follow-up data (mean age=68.5 years (SD=13.5 years)) were included. 53 participants (49%) fell following stroke, of whom 28 (26%) had recurrent falls. Estimated mean total healthcare cost was €20,244 (SD=€23,456). The experience of one fall and recurrent falls was independently associated with higher costs of care (p=0.02 and p<0.01, respectively). Discussion: The observed relationship between falls and cost is likely to be underestimated as aids and adaptions, productivity losses, and nursing home care were not included. Conclusion: This study points at differences across fall-status in several healthcare costs categories, namely the index admission, secondary/ tertiary care (including inpatient re-admissions) and allied health care. Future research could compare the cost-effectiveness of inpatient versus communitybased fall-prevention after stroke. Further studies are also required to inform post-stroke bone-health management and fracture-risk reduction

Supplemental material for First year post-stroke healthcare costs and fall-status among those discharged to the community

<p>Supplemental material for First year post-stroke healthcare costs and fall-status among those discharged to the community by Mary E Walsh, Jan Sorensen, Rose Galvin, David JP Williams, Joseph A Harbison, Sean Murphy, Ronan Collins, Dominick JH McCabe, Morgan Crowe and N Frances Horgan: Central Statistics Office in European Stroke Journal</p

Enhancing existing formal home care to improve and maintain functional status in older adults: protocol for a feasibility study on the implementation of the Care to Move (CTM) programme in an Irish healthcare setting

An increasing ageing population leads to greater demand for care services to help maintain people in their own homes. Physical activity programmes have been shown to improve older adults’ functional capacity, enabling the older adult to live independently and maintain functional status. There has been a lack of quality research conducted around physical activity within the landscape of home care services. We describe a feasibility study of implementing the Care to Move (CTM) programme in older adults receiving low-level home care. A Phase 1 mixed-methods feasibility study design will explore the recruitment, attrition, retention, costs to deliver and data loss. It will also explore the acceptability and impact of the CTM programme on older adults and thematic analysis of data collected from older people, home care workers and relevant stakeholders through use of semi-structured interviews and focus groups. We will measure functional status and fall outcomes in older adults receiving low levels of home care, facilitating this population to continue living independently at home and providing data currently not known around this group