Gaps in U.S Stroke Rehabilitation Highlighted in New Policy Statement

A new policy statement from the American Heart Association highlights major gaps in U.S stroke rehabilitation and identifies needed improvements in public policies and performance measures to incentivize optimal patient care. The statement, published in the peer-reviewed scientific journal Stroke, emphasizes the need for patient-centered stroke rehabilitation, better data, and reduced disparities to improve recovery outcomes. With stroke being a leading cause of long-term disability in the United States, the American Heart Association calls for developing and implementing performance measures that incentivize optimal patient care and improve stroke rehabilitation overall.

Key Takeaways:

• The policy statement outlines key measures to improve stroke care, including advancing research that reflects real-world stroke recovery challenges, developing a national data infrastructure to track rehabilitation service utilization, and comparing rehabilitation models for their clinical effectiveness and cost-efficiency.
• The statement highlights the need to study the impact of systemic factors, such as insurance coverage, geography, health systems, and payment models, on rehabilitation quality and patient recovery to inform improvements in care delivery.
• The American Heart Association advocates for enhancing care coordination and discharge planning by expanding staff training and addressing the unique needs of patients and their caregivers from varied social and economic backgrounds.
• The policy statement emphasizes the importance of equitable access to stroke rehabilitation services, regardless of ZIP code, insurance status, or the cultural competency of healthcare providers.
• The American Heart Association is committed to advancing public policies at the federal and state levels that create optimal systems of care for stroke treatment, including rehabilitation and recovery.
• The policy statement was prepared by the volunteer writing group on behalf of the American Heart Association Advocacy Coordinating Committee.

Statistics:

• The economic burden of stroke is expected to increase by more than five-fold between 2020 and 2050, from $67 billion to $423 billion, making it one of the most expensive medical conditions covered by Medicare.
• Stroke is the leading cause of long-term disability in the United States.
• Despite advances in stroke treatment, systems designed to support stroke survivors in recovery continue to fall short of the needs of patients, with large gaps in care based on race, geography, insurance type, and socioeconomic status.
• Access to stroke rehabilitation care is often not determined by clinical need, with some patients facing steep barriers to accessing post-acute rehabilitation services, widening the disability gap compared to stroke survivors in urban areas.

Sources:

• "Improving Access to Stroke Rehabilitation and Recovery -- A Policy Statement from the American Heart Association / American Stroke Association," American Heart Association, Stroke, DOI: 10.1161/STR.0000000000000493.
• "Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association," Circulation, DOI: 10.1161/CIR.0000000000001258.
• "Our Policy Positions | American Heart Association," American Heart Association, https://www.heart.org/en/get-involved/advocate/policy-research/our-policy-positions.