Post-acute care regains quality of life among middle-aged and older stroke patients in Taiwan

Objective: This study aims to evaluate health-related quality of life (HRQoL)of middle-aged and older stroke patients receiving the stroke post care (PAC)program and to identify possible predictors. Design, setting and participants: This is a retrospective cohort study. Demographic characteristics and functional outcomes (modified Rankin Scale, Barthel Index, Mini-Mental State Examination, and the Concise Chinese Aphasia Test)were collected at enrollment. EQ-5D HRQoL questionnaires were administered at the beginning and the end of PAC, and health state utilities were compared. Results: The EQ-5D utilities of stroke patients aged 75–84 years and 85 years or above were estimated to be 0.091 and 0.159 lower than those aged less than 50 years. A decrease of the utility by 0.075 was observed among patients with the prior history of stroke. The EQ-5D utilities of patients having Barthel Index of 21–40, 41–60, and 61–100 were 0.1432, 0.1568, and 0.1387 higher than those having Barthel Index of 0–20, respectively. For patients reporting extreme problems in self-care or any dimension of EQ-5D questionnaires prior to PAC, increases in utilities by 0.0733 and 0.2875 were noted. The EQ-5D utility of PAC service duration rose by 0.0733 per one incremental day. Conclusions and implications: This study provides vital evidence regarding time-varying benefits of PAC services to HRQoL of stroke patients and to identify multiple predictors of HRQoL among stroke patients receiving PAC services. This study thus could serve as good reference to enhance quality of PAC services among stroke patients.