Availability and barriers to access post-stroke rehabilitation in Latin America
Rosales, J. De Souza, A. Corredor-Quintero, A. Barboza, M.A. Navia-Gonzalez, V. Brunet-Perez, F. Lagos-Servellon, J. Novarro-Escudero, N. Ortega-Moreno, D.A.
Rosales, J.
De Souza, A.
Corredor-Quintero, A.
Barboza, M.A.
Navia-Gonzalez, V.
Brunet-Perez, F.
Lagos-Servellon, J.
Novarro-Escudero, N.
Ortega-Moreno, D.A.
Publication Date
2024-10
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Rights
(c) 2024 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)
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Yes
Open Access status
openAccess
Accepted for publication
2024-08-02
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Abstract
Objectives
To describe the availability and barriers to access post-stroke rehabilitation services in Latin America.
Materials and methods
We conducted a multi-national survey in Latin American countries. The survey consisted of three sections: (1) the national state of post-stroke rehabilitation; (2) the local state of post-stroke rehabilitation; and (3) the coverage and financing of post-stroke services. Stroke leaders from the surveyed countries were involved in developing and disseminating the survey.
Results
261 responses were collected from 17 countries. The mean age of respondents was 42.4 ± 10.1 years, and 139 (54.5 %) of the respondents were male. National clinical guidelines for post-stroke rehabilitation were reported by 67 (25.7 %) of the respondents. However, there were discrepancies between respondents within the same country. Stroke units, physiotherapy, occupational therapy, speech therapy, and neuropsychological therapy services were less common in public than private settings. The main barriers for inpatient and outpatient services included limited rehabilitation facilities, coverage, and rehabilitation personnel. The main source of financing for the inpatient and outpatient services was the national health insurance, followed by out-of-pocket payments. Private and out-of-pocket costs were more frequently reported in outpatient services.
Conclusions
Post-stroke rehabilitation services in Latin American countries are restricted due to a lack of coverage by the public health system and private insurers, human resources, and financial aid. Public settings offer fewer post-stroke rehabilitation services compared to private settings. Developing consensus guidelines, increasing coverage, and using innovative approaches to deliver post-stroke rehabilitation is paramount to increase access without posing a financial burden.
Version
Published version
Citation
Gonzalez-Aquines A, Rosales J, De Souza AC et al (2024) Availability and barriers to access post-stroke rehabilitation in Latin America. Journal of Stroke and Cerebrovascular Diseases. 33(10): 107917.
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Article