Effects of a continuing care program based on the long-term care insurance policy for stroke survivors: a quasi-experimental trial

Abstract

Background There were 28.76 million stroke patients in China, with 3.94 million new strokes annually. Around 70% of survivors live with varying degrees of permanent disability, placing a heavy burden on families and society. Stroke patients have a complex and high need for continuing care services after discharge from the hospital. The study was to evaluate the effectiveness of the continuing care program on the activity of daily life, the degree of disability, stroke recurrence and readmission in patients with stroke, based on the long-term care insurance policy. Methods Eighty-eight stroke patients were recruited from February 2021 to January 2022. They were allocated to either intervention group (N = 44) or control group (N = 44) based on whether the long-term care insurance application was successful. The intervention consisted of discharge education, 3-month in-home care and remote counseling. The activity of daily life, disability, recurrence and readmission of patients were evaluated between the groups before the intervention, at 1, 2, 3 and 6 months after discharge. Results There were no statistically significant differences between the groups in clinical characteristics at baseline. We detected significant interaction effects between time and group (p < 0.001), indicating that the scores of two outcomes changed differently over time in intervention and control groups. It was found that the participants of the intervention group had a statistically significant improvement in activity of daily life and disability than the control group at baseline and follow-up periods. The decrease in readmission of the intervention group was statistically significant than in the control group (χ2 = 6.040, p = 0.014; χ2 = 7.216, p = 0.007) at 1 and 2 months after discharge, but no significant difference was found at 3 and 6 months after discharge. At follow-up, there was no significant difference between groups regarding stroke recurrence rates (p > 0.05). Conclusions This study demonstrates the positive effects of a continuing care program based on the long-term care insurance policy on activity of daily life and disability in people with stroke. The effectiveness and feasibility of this intervention program suggest that its application should be promoted to promote the care and rehabilitation of stroke patients. Trail registration: The trail was not registered as a quasi-experimental trail.