Abstract 2901: Do working-aged stroke survivors experience economic hardship in Australia? The Psychosocial Outcomes In Stroke (POISE) Study

Abstract

Introduction: Approximately 12,000 working-aged Australians survive a stroke each year. Most will experience some level of disability during their recovery which can negatively affect the economic well-being of their household. The economic consequences include unemployment, reduction in paid employment and changes in career for both the patient and often a family carer. There are also unbudgeted costs associated with medical care, home modifications, transport and paid care. Thus, recovery from stroke can be associated with substantial household economic hardship. This study is the first to investigate the household economic burden of stroke recovery in working-aged Australians. Methods: This was a multi-centre, three year cohort study that recruited a representative sample of younger (< 65 years) stroke survivors to determine the modifiable psychosocial and economic predictors of subsequent return to work. Participants were recruited from the New South Wales Stroke Services network. This paper reports a secondary analysis of the predictors of economic hardship associated with stroke recovery. Hardship was measured using questions about financial stress and financial coping strategies employed. Results: A total of 416 participants completed assessments at baseline (pre-stroke) and at six and 12 months after their stroke. At baseline, 36% of participants reported hardship. This increased to 52% at six months and fell to 44% at 12 months and included 137 new cases of hardship post-stroke. The main sources of financial stress reported at 12 months included: utility bills (21%), rent and mortgage payments (15%), medications and medical equipment (10%) and medical care (9%). To maintain expenses at one year, participants most frequently used their savings (40%) and borrowed money (20%). The baseline variables that predicted hardship post-stroke included: gender (females versus males; OR, 2.3; 95% CI, 1.3 to 4.3), level of alcohol consumption (heavy drinker versus not a heavy drinker; OR, 2.3, 95% CI, 1.1 to 5.1) and economic hardship at baseline (OR, 3.1; 95% CI, 1.8 to 5.4). Conclusion: Despite strong health and social welfare supports in place in Australia, this study demonstrates that younger stroke survivors experience considerable economic hardship during their recovery. We have identified the main sources of financial stress for this cohort and a sub-group of patients who may be most at risk of experiencing hardship. This research provides a basis to investigate the additional policy supports required to better assist stroke survivors in Australia.