[A cross-sectorial analysis of physio and occupational therapy pathways after stroke].

PURPOSE: This article examines the provision of physiotherapy and occupational therapy for stroke patients from a cross-sectorial perspective, from acute to rehabilitative care to outpatient services.
METHODS: The sample comprises all clients of the Deutsche BKK, a large German health insurance company, who received acute care for stroke in 2007, who survived the initial hospital stay, and who had a secondary diagnosis of motor deficits (n = 1 929).
RESULTS: For 60.4% of these stroke patients, no further treatment was provided after acute care. The odds of receiving early rehabilitation treatment while in hospital stay decreased by 1% with each year of life. Only 18.8% of patients received a form of treatment that was largely in line with current recommendations for stroke care, beginning with early rehabilitation and including further treatment in the context of rehabilitation measures or outpatient care. Patients who were in long-term nursing care before stroke were at increased risk of not being placed on this treatment pathway, which has been positively evaluated. 20.7% of patients did not receive any early rehabilitation treatment, but received further rehabilitation treatment and/or outpatient services after hospital discharge.
CONCLUSIONS: We recommend that receipt of long-term nursing care should routinely be regarded as a risk factor for underprovision of treatment after stroke (yellow flag). © Georg Thieme Verlag KG Stuttgart · New York.