The proposed study will generate a national mapping of healthcare utilization patterns in people post-stroke in the chronic phase living in the community; examine the associations between individual-level characteristics, health outcomes and healthcare utilization; and will describe patients' perspectives on their needs for health services and their experiences of using them.
The study will use mixed-methods methodology (quantitative and qualitative) and will proceed in three parts. In part 1, data will be extracted retrospectively from electronic medical records of of Clalit Health Services, covering all patients with a stroke diagnosis. In part 2, a sub-sample of 240 patients will be asked to answer standardized questionnaires. In part 3, a sub-sample of 20 participants will participate in in-depth, semi-structured interviews.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria for the retrospective study (Part 1):
* People diagnosed with stroke (First stroke occurred between 2010-2022)
* At least one year after the event
* Living in the community
* Aged 18 and above
* Insured by HMO (Clalit health services)
Exclusion Criteria for the retrospective study (Part 1):
* Stroke chronicity of less than a year
* Diagnosis of TIA (Transient Ischemic Attack)
Inclusion Criteria for the cross-sectional and qualitative study (Parts 2\&3):
* People diagnosed with stroke
* Hospitalized for a first stroke at the 'Carmel' Medical Center between 2010-2022
* Understand Hebrew/ Arabic/ Russian in a way that allows them to understand the consent form and answer the survey questions.
Exclusion Criteria for the cross-sectional and qualitative study (Parts 2\&3):
* Stroke chronicity of less than a year the study
* Transient ischemic attack (TIA)
* Patients who have a guardian, a nursing condition as a result of diseases other than stroke or other serious background diseases that impair function, people with communication difficulties that do not allow answering questionnaires or to be interviewed.
Primary outcome measure(s)
Visits to a neurologist — 1 year Monitoring the number of annual visits to a neurologist in the chronic phase of the disease.
Extraction and analysis of data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.
Use of physical therapy services — 1 year Monitoring the number of annual visits to physical therapy services in the chronic phase of the disease.
Extraction and analysis of data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.
Stroke impact Scale - SIS 3.0 — 1 hour The SIS-3.0 questionnaire evaluate how the stroke has impacted patients' health and life.
It composed of 59 items investigating 8 domains (strength, hand function, mobility, activities of daily living, emotion, memory, communication, social participation) and also assesses the degree of recovery from the stroke. Range of scores is 0-100. Each item is scaling by a 5-point scale from 1 to 5. The questionnaire will be evaluated for a sub-sample of 250 patients.
Visits to the emergency medicine center and urgent hospitalization data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke. — 1 year Monitoring the number of annual visits to the emergency medicine center and the number of urgent hospitalization in the chronic phase of the disease.
Extraction and analysis of data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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