dc.contributor.author
Schindel, Daniel
dc.contributor.author
Mandl, Lena
dc.contributor.author
Schilling, Ralph
dc.contributor.author
Meisel, Andreas
dc.contributor.author
Schenk, Liane
dc.date.accessioned
2022-08-23T13:29:08Z
dc.date.available
2022-08-23T13:29:08Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/36003
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-35718
dc.description.abstract
Background: Impairments to comprehension and production of speech (aphasia, dysarthria) and swallowing disorders (dysphagia) are common sequelae of stroke, reducing patients’ quality of life and social participation. Treatment oriented on evidence-based guidelines seems likely to improve outcomes. Currently, little is known about guideline adherence in stroke aftercare for the above-mentioned sequelae. This study aims to analyse guideline adherence in the treatment of aphasia, dysarthria and dysphagia after stroke, based on suitable test parameters, and to determine factors that influence the implementation of recommended therapies.
Methods: Six test parameters were defined, based on systematic study of guidelines for the treatment of speech impairments and swallowing disorders (e.g. comprehensive diagnostics, early initiation and continuity). Guideline adherence in treatment was tested using claims data from four statutory health insurance companies. Multivariate logistic and linear regression analyses were performed in order to test the outcomes.
Results: 4,486 stroke patients who were diagnosed with specific disorders or received speech therapy were included in the study. The median age was 78 years; the proportion of women was 55.9%. Within the first year after the stroke, 90.3% of patients were diagnosed with speech impairments and swallowing disorders. Overall, 44.1% of patients received outpatient speech and language therapy aftercare. Women were less frequently diagnosed with specific disorders (OR 0.70 [95%CI:0.55/0.88], p = 0.003) and less frequently received longer therapy sessions (OR 0.64 [95%CI:0.43/0.94], p = 0.022). Older age and longer hospitalization duration increased the likelihood of guideline recommendations being implemented and of earlier initiation of stroke aftercare measures.
Conclusions: Our observations indicate deficits in the implementation of guideline recommendations in stroke aftercare. At the same time, they underscore the need for regular monitoring of implementation measures in stroke aftercare to address group-based disparities in care.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Deglutition Disorders
en
dc.subject
Guideline Adherence
en
dc.subject
Insurance Claim Review
en
dc.subject
Insurance, Health
en
dc.subject
Language Therapy
en
dc.subject
Multivariate Analysis
en
dc.subject
Speech Therapy
en
dc.subject
Stroke Rehabilitation
en
dc.subject
Treatment Outcome
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Guideline adherence in speech and language therapy in stroke aftercare. A health insurance claims data analysis
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
e0263397
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0263397
dcterms.bibliographicCitation.journaltitle
PLOS ONE
dcterms.bibliographicCitation.number
2
dcterms.bibliographicCitation.originalpublishername
Public Library of Science (PLoS)
dcterms.bibliographicCitation.volume
17
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
35113968
dcterms.isPartOf.eissn
1932-6203