The public primary health care facilities in this country are well equipped to provide chronic long-term care. As post stroke care is multidisciplinary, there is a need to optimize the current health care delivery system to benefit stroke survivors and their caregivers. To date, data on in-patient admissions for stroke are only available from the northern parts of Malaysia – mainly from Penang and Terengganu. The lack of data on the national prevalence and long-term outcomes of stroke patients in this country calls for better coordination among the providers of stroke care. However, a review of the 10th Malaysian Plan revealed problems associated with access to and inequity in specialized care (such as stroke care services), and consolidation of the current health care service has been identified as a solution. Malaysia, in its bid to achieve the status of a developed nation, has a fairly well-established public health system to cater to its expanding population. ĭeveloping countries face added challenges in terms of access to specialized stroke care services and the lack of adequately trained staff members to provide continuity of stroke rehabilitation once patients are back in the community. In most public health systems around the world, fragmentation and poor coordination of care have been the greatest obstacles in ensuring adequate post stroke care and rehabilitation. Post stroke care delivery requires the coordination of multidisciplinary service provision intersectoral collaboration within the public health care delivery system is vital to ensure that patients continue to receive optimal post stroke care once they are discharged from hospital following acute stroke. Although stroke is an acute affliction, its long-term complications and disabilities require long-term dependency on the public health care system. Advancements in medical technologies have improved the mortality rates among stroke patients, resulting in one third of afflicted stroke patients worldwide surviving with permanent disabilities in their advancing years. Stroke is a major global public health problem in terms of mortality and disability, and its incidence is expected to increase over the next 20 years as the world population ages. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services.
![source code program delphi perpustakaan tuanku source code program delphi perpustakaan tuanku](https://i2.wp.com/cctvdesk.com/wp-content/uploads/2018/09/hik-connect-for-pc-5.png)
ConclusionĬoordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems.
![source code program delphi perpustakaan tuanku source code program delphi perpustakaan tuanku](https://ascelibrary.org/cms/attachment/7c0d9763-8505-465d-a080-d68c0227b60c/figure2.jpg)
Shared care approaches with Specialist Stroke care team were outlined. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Essential information required during transfer of care from tertiary care to primary care providers was identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Indication for patients eligible for monitoring by primary care at public health centres were identified. Care algorithms were designed around existing work schedules at public health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. MethodsĮxpert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted.
![source code program delphi perpustakaan tuanku source code program delphi perpustakaan tuanku](https://educationdocbox.com/docs-images/78/78263855/images/45-0.jpg)
A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase.