Factors Influencing CVA Patients to Seek Rehabilitative Care

Abstract

FEW COMMUNIT'IES anywhere in the world provide public health workers with all the resources desirable to maintain optimum public health. Since this s,ituation will prevail for some time, efforts are increasing to improve the efficiency of available programs and reduce the need for immediate expansion. One way of raising efficiency is to insure t,hat future participants will be those who need and will benefit most from the, programs. The first step is to study current participation in each public health program and to compare the participants with the population group for whom the program was designed. Later, the difficult but crucial phase is to identify the reasons for inadequate use and to take all practical steps to insure more idea,l participation in the future. In the field of chronic illness, in which early diagnosis and care are widely urged, evidence is increasing that the socioeconomic and behavioral patterns of long-term patients, their families, and their physicians tend to prevent satisfactory use of existing medical knowledge and community facilities (1-9). In at least some areas of the United States, for example, rehabilitation centers are inefficiently used because patients wait too long before applying for admission (7). This harmful delay is the main issue in this report. The purpose of this study is to test the hypothesis that, following the onset of cerebrovascular accidents, patients applying most rapidly for rehabilitative care tend to be those with few resources for staying in a more homelike environment. The hypothesis implies that prompt applicants seem neither to have a positive desire to be rehabilitated nor to represent the group likely to benefit most from rehabilitative care; rather, they consist of patients whose socioeconomic and medical circumstances play a large part in their applying to, what may seem to them, one of their last resources for care.