Acesso à reabilitação e georreferenciamento de indivíduos pós-avc em Fortaleza-CE

Abstract

In 20 years, the incidence of stroke in the world increased by 70.0%, being one of the main causes of death and disability in Brazil. In Ceará, there was an increase in the absolute number of hospitalizations for stroke by 17.3% from 7,436 in 2009 to 8,719 in 2020. According to the Adult Stroke Care Line, after hospital discharge, the patient must be referred to a Primary Care Unit for care management and secondary prevention and, if necessary, should be advised to seek a rehabilitation service. Regardless of the degree of disability, early initiation and continuity of physiotherapeutic treatment are essential for the rehabilitation prognosis. In accordance with the organizational principles of Regionalization and Hierarchization of the Unified Health System (SUS), based on the epidemiological data of a population, a plan must be carried out for actions and services to be offered in health units to meet the demand of each regional population. The territories of Fortaleza are thus divided into 12 regions. This study aims to investigate access to rehabilitation for post-stroke individuals treated at the Neurofunctional Physiotherapy outpatient clinic of the FisioNeuro Group Extension Project, and relate it to clinical, contextual and disability factors. This is an analytical cross-sectional study with a quantitative approach, developed at the Department of Physiotherapy at the Federal University of Ceará (UFC). Data from 186 participants were analyzed. A descriptive analysis was carried out, construction of a georeferencing map of patients and an inferential analysis with the variables time since stroke, level of disability according to the Modified Rankin Scale (EMR), stroke recurrence, hospital care after discharge, education, income, physical activity and use of orthotics. Individuals with higher income had more access to rehabilitation after hospital discharge. Furthermore, regardless of the region where they resides, they did not have greater opportunity to access Physiotherapy. This demonstrates the need for further investigation into the factors influencing access to rehabilitation in this population.