Abstract P213: Identification of Rural Needs and Gaps of Stroke Care Rehabilitation: Results From a Statewide Healthcare Provider and Stroke Patient Survey

Abstract

Introduction: Urban and rural stroke care disparities are pervasive for post-acute stroke rehabilitation. Mission:Lifeline Stroke conducted a needs assessment to identify needs and gaps in care for stroke rehabilitation throughout rural Nebraska (NE). Purpose: The assessment included surveys of healthcare providers (HCPs) and stroke survivors to inform a robust understanding of stroke rehabilitation needs across NE, addressing barriers and facilitators to care, including outpatient therapy, social support, equipment, and patient-facing resources. Methods: HCPs were recruited through the Nebraska Stroke Advisory Council to complete a 17-question online survey. Survivors in NE were recruited through social media and existing stroke support groups to complete a 26-question online survey. Results: Respondents of the HCP survey (N=260) identified the top barrier to providing care to survivors as lack of insurance (62%), lack of caregiver support (42%), and lack of specialized services (42%). Respondents of the survivor survey (N=30) identified top barriers as lack of insurance (74%), financial burden (64%), and lack of caregiver/social support (50%). Both HCPs’ and survivors identified lack of caregiver and social support as resources missing from their community, and survivors identified communication about support groups or sources of emotional support (n=4) as the top missing resource. In addition, 39% of survivors indicated an interest in attending a support group. HCPs indicated missing resources primarily include specialized rehab equipment, technology, and services (52%), and professional opportunities for staff (37%). Regarding resources provided to survivors, most HCPs indicated community resources (94%) are provided, proceeded by follow-up/continued outpatient therapy (88%). In slight contrast, survivors indicated the top resources they learned of when discharged were outpatient physical therapy (82%), outpatient occupational therapy (70%), and outpatient speech therapy (56%). Conclusion: Although both healthcare providers and survivors identified outpatient therapies are made available, there is a need for more communication about support groups and physical resources such as rehab equipment, technology, and services.