Background and Aims: After a stroke families require the coordinated assistance of health and social care. There is a lack of comprehensive evaluation and assessment tools to identify discharge needs and there is separate management of the health and social resources, and access to these services is variable between regions.
Materials and Methods: This was a 2-year prospective and community study of a stroke cohort. The primary outcome was recognized dependency. The potential predictors were considered in a multivariate regression, and receiver operating characteristic (ROC) curves were used to predict dependency.
Results: Overall, 233 patients were included, 49.8% of whom were women. The total rate of dependency was 31.5 (95% CI 26.1-37.7) cases/100 person-year, but 30.4% became dependent prior to the stroke. The independent factors associated with dependency outcome were: age >80 years (HR 2.03, 95% CI 1.32–3.12, p=0.001), Pfeiffer score ≥4 (HR 1.82, 95% CI 1.25–1.2.66, p=0.002), Barthel score <60 (HR 1.79, 95% CI 1.21-2.66, p=0.003), and Charlson score ≥3 (HR 1.49, 95% CI 1.02-2.16, p=0.039). The AUC was 0.84 (95% IC 0.79-0.89; p <0.001), and the App Health+Social was associated with time-savings.
Conclusions: The use of alarm conditions can ease the burden for the application to Dependency by supporting the integrated role of social and health services.
Trial registration: ClinicalTrials.gov number NCT03451357. Date of clinical registration March 1, 2018.