Olafsdottir SA1, Galvin R2, Hafsteinsdottir TB3, Hjaltadottir I4, Jonsdottir H4, Arnadottir SA5
1University of Iceland, School of Health Sciences, Reykjavík, Iceland, 2University of Limerick, School of Allied Health, Limerick, Ireland, 3University Medical Center Utrecht, Department of Rehabilitation, Nursing Science and Sport, Utrecht, Netherlands, 4University of Iceland, Faculty of Nursing, Reykjavík, Iceland, 5University of Iceland, Department of Physical Therapy, Reykjavík, Iceland
Background: External societal and health care factors are more likely to affect older people, including stroke survivors. Ageism appears to be quite common in stroke rehabilitation and rate of rehabilitation services are lower for older stroke survivors compared to younger. In Iceland, governmental restrictions in 2003, lead to a sharp decrease in number of physical therapists (PTs) providing outpatient physical therapy (OPT) services and the period from 2008 to 2011 is well-known as the Icelandic financial crisis.
Purpose: The purpose of this study was to investigate potential changes in the proportion of older adults (65+ years) among stroke survivors who received OPT in 2001-2015 and compare these potential changes with external societal events in Iceland.
Methods: This research is based on total population data from a national registry with information on: all OPT cases (N=659.365) reimbursed by Icelandic Health Insurances from 2001 to 2015, and all physical therapists (PTs) providing this service. The analysis included OPT clients with the diagnosis ICD I60-66 and I69.
Results: In 2001, 1.4% of all OPT cases were stroke survivors and 1.2% in 2015. Among stroke survivors using OPT, the proportion of older adults was 70.4% (316/449) in 2001 and 70.6% (411/582) in 2015. In the period between these time points, this proportion peaked in 2003 (73.2%, 374/511) and decreased down to 67.9% (324/477) in 2004. After four years with little changes, the year of 2008 marked the beginning of a new decline with a low point of 64.9% (382/589) in 2011. Since then, the proportion of older adults within this patient population has gradually been rising.
Conclusion(s): These findings show that older adults are most prevalent among stroke survivors using OPT services in Iceland and that external events may influence older stroke survivors' accessibility to OPT more than the younger ones.
Implications: It is important for PTs to be aware of the fact that older stroke survivors might me more vulnerable to changes in services. PTs should therefore be prepared at all times to advocate for their older clients suffering from stroke.
Keywords: Outpatient physical therapy, older stroke survivors, external factors
Funding acknowledgements: The Icelandic Physiotherapy Association, NordForsk
Purpose: The purpose of this study was to investigate potential changes in the proportion of older adults (65+ years) among stroke survivors who received OPT in 2001-2015 and compare these potential changes with external societal events in Iceland.
Methods: This research is based on total population data from a national registry with information on: all OPT cases (N=659.365) reimbursed by Icelandic Health Insurances from 2001 to 2015, and all physical therapists (PTs) providing this service. The analysis included OPT clients with the diagnosis ICD I60-66 and I69.
Results: In 2001, 1.4% of all OPT cases were stroke survivors and 1.2% in 2015. Among stroke survivors using OPT, the proportion of older adults was 70.4% (316/449) in 2001 and 70.6% (411/582) in 2015. In the period between these time points, this proportion peaked in 2003 (73.2%, 374/511) and decreased down to 67.9% (324/477) in 2004. After four years with little changes, the year of 2008 marked the beginning of a new decline with a low point of 64.9% (382/589) in 2011. Since then, the proportion of older adults within this patient population has gradually been rising.
Conclusion(s): These findings show that older adults are most prevalent among stroke survivors using OPT services in Iceland and that external events may influence older stroke survivors' accessibility to OPT more than the younger ones.
Implications: It is important for PTs to be aware of the fact that older stroke survivors might me more vulnerable to changes in services. PTs should therefore be prepared at all times to advocate for their older clients suffering from stroke.
Keywords: Outpatient physical therapy, older stroke survivors, external factors
Funding acknowledgements: The Icelandic Physiotherapy Association, NordForsk
Topic: Neurology: stroke; Neurology: stroke; Older people
Ethics approval required: Yes
Institution: the Icelandic Health Insurances
Ethics committee: The Icelandic National Bioethics Committee
Ethics number: VSNb2015100032/03.03
All authors, affiliations and abstracts have been published as submitted.
