Early access to physical therapy after hospital discharge from a Stroke Unit in Joinville.

Abstract

Objective. To characterize access to rehabilitation after stroke in the public health system of the health region of Joinville, and the barriers and facilitators encountered by users. Method. An observational, longitudinal, and prospective study was conducted at the Stroke Unit of São José Municipal Hospital between April and July 2023. The sample included stroke patients aged ≥18 years, indicated for physiotherapy rehabilitation, and who signed the Informed Consent Form. Participants were assessed using a sociodemographic and clinical questionnaire, as well as an access questionnaire 30 days after hospital discharge. Results. A total of 45 patients were included, with a mean age of 65.12±13.47 years, primarily from Joinville municipality (67.5%). Most had risk factors such as hypertension (70.0%) and diabetes (52.5%). After discharge, 65.0% started rehabilitation within 30 days, with a mean of 8.5±7.7 days in the region and 14.5±9.8 days in Joinville. Having personal transportation was a facilitator (61.5%), while waiting lists at SUS clinics were the main barrier (35.0%). Conclusions. Access to rehabilitation was effective for more than half of the patients within 30 days, with indicators similar to or higher than those reported in Brazilian literature. Facilitators included established protocols, a multidisciplinary team, health education strategies, referral at discharge, and personal transportation. The main barrier was waiting lists at public services, hindering early access and leading users and families to seek private services.