Supporting Return-to-Work and Care Continuity After Stroke: Evaluation of the SLS CHARTER Coordinated Care Model
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The Stroke Life Support Central Health Alliance, Registry & Technology Enabled caRe (SLS CHARTER) Programme addresses stroke patients’ rehabilitation needs through timely evaluation and intervention, but it has not been evaluated. This study evaluated the programme’s outcomes over 6 months. 206 SLS and 55 control participants recruited from a restructured hospital in Singapore were included for the final analysis. The primary outcome was Post Stroke Checklist (PSC) usage per SLS participant. Secondary economic outcomes included healthcare utilisation and return to work (RTW). Multivariate analyses, adjusted for demographics and clinical factors, used gamma-log link and Poisson regression for healthcare utilisation, and logistic and Cox regression for RTW outcomes, to evaluate associations with intervention status. PSC usage increased from 50.5% 1-month post stroke to 86.9% 6-month post stroke; mean utilisation rose from 1.76 to 4.25. SLS participants reported longer lengths of stay (LOS) in certain sub-acute rehabilitation institutions and less day care visits. Additionally, there was varying RTW for different patient subgroups. Our findings suggest the SLS CHARTER Programme increases PSC usage, which is useful to guide future care coordination programmes. Identification of patients at risk of poorer RTW, for proactive occupational rehabilitation, may help to reduce the economic burden of stroke.
