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Gonzalez-Aquines A, Rosales J, De Souza AC, Corredor-Quintero A, Barboza MA, Navia-Gonzalez V, Brunet-Perez F, Lagos-Servellon J, Novarro-Escudero N, Ortega-Moreno DA, Villarroel-Saavedra V, Abanto C, Barrientos-Guerra JD, Saltos-Mata F, Papavasileiou V, Todd O, Gongora-Rivera F. Availability and barriers to access post-stroke rehabilitation in Latin America. J Stroke Cerebrovasc Dis 2024; 33:107917. [PMID: 39111374 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES To describe the availability and barriers to access post-stroke rehabilitation services in Latin America. MATERIALS AND METHODS We conducted a multi-national survey in Latin American countries. The survey consisted of three sections: (1) the national state of post-stroke rehabilitation; (2) the local state of post-stroke rehabilitation; and (3) the coverage and financing of post-stroke services. Stroke leaders from the surveyed countries were involved in developing and disseminating the survey. RESULTS 261 responses were collected from 17 countries. The mean age of respondents was 42.4 ± 10.1 years, and 139 (54.5 %) of the respondents were male. National clinical guidelines for post-stroke rehabilitation were reported by 67 (25.7 %) of the respondents. However, there were discrepancies between respondents within the same country. Stroke units, physiotherapy, occupational therapy, speech therapy, and neuropsychological therapy services were less common in public than private settings. The main barriers for inpatient and outpatient services included limited rehabilitation facilities, coverage, and rehabilitation personnel. The main source of financing for the inpatient and outpatient services was the national health insurance, followed by out-of-pocket payments. Private and out-of-pocket costs were more frequently reported in outpatient services. CONCLUSIONS Post-stroke rehabilitation services in Latin American countries are restricted due to a lack of coverage by the public health system and private insurers, human resources, and financial aid. Public settings offer fewer post-stroke rehabilitation services compared to private settings. Developing consensus guidelines, increasing coverage, and using innovative approaches to deliver post-stroke rehabilitation is paramount to increase access without posing a financial burden.
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Affiliation(s)
| | - Julieta Rosales
- Vascular Neurology Division, Department of Neurology, Fleni, Argentina. Montañeses, 2325, Buenos Aires, Argentina
| | - Ana Claudia De Souza
- Neurology and Neurosurgery Department, Hospital Moinhos de Vento, Brazil. Rua Ramiro Barcelos, 910, Bairro Moinhos de Ven, Porto Alegre, RS, 90.035-001
| | - Angel Corredor-Quintero
- Centro de ACV, Departamento de Neurología, Clínica Central del Quindío, Armenia, Colombia. Carrera 13 # 1N - 35, Armenia, Quindío, Colombia
| | - Miguel A Barboza
- Departamento de Neurociencias, Hospital Dr. Rafael A. Calderón Guardia, CCSS. San José, Costa Rica. Avenidas 7 y 9, calles 15 y 17, C. 17, San José, Aranjuez, Costa Rica
| | - Victor Navia-Gonzalez
- Facultad de Medicina, Clínica Alemana, Departamento de Neurologia, Universidad del Desarrollo, Chile. Avenida Manquehue Norte, 1410, Chile
| | | | - Javier Lagos-Servellon
- Hospital Nacional Mario Catarino Rivas, GXG5+665, 1 Calle, 21102, San Pedro Sula, Cortés, Honduras; Hospital CEMESA, 21 Calle A, 21104, San Pedro Sula, Honduras
| | - Nelson Novarro-Escudero
- Primary Stroke Center, Pacifica Salud, Panama. Pacific Boulevard and, Blvd, Pacífica, Panamá, Panama; Centro de Neurociencias, Ciudad de la Salud, Caja de Seguro Social, Panamá
| | - Diego A Ortega-Moreno
- Department of Neurology, University Hospital, Universidad Autonoma de Nuevo Leon, Gonzalitos y Madero S/N, Monterrey, Nuevo Leon, Mexico
| | - Victor Villarroel-Saavedra
- Hospital Obrero N 2-seguro de la Caja Nacional de Salud, Cochabamba, Bolivia. Av. Avenida Blanco Galindo km 5 ½, Bolivia
| | - Carlos Abanto
- Departamento de Enfermedades Neurovasculares, Instituto Nacional de Ciencias Neurológicas, Jr. Ancash 1271, Barrios Altos, Lima, Perú
| | | | - Filadelfo Saltos-Mata
- Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador. Q482+VGH, Av. 25 de Julio, Guayaquil, 090203, Ecuador
| | - Vasileios Papavasileiou
- Department of Neurosciences, Leeds Teaching Hospitals NHS Trust, England, St. James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF; School of Medicine, Faculty of Medicine and Health, University of Leeds, England, University of Leeds Woodhouse Lane Leeds, LS2 9JT
| | - Oliver Todd
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds, England, LS2 9LH, UK; Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, England, BD9 6RJ, UK
| | - Fernando Gongora-Rivera
- Department of Neurology, University Hospital, Universidad Autonoma de Nuevo Leon, Gonzalitos y Madero S/N, Monterrey, Nuevo Leon, Mexico
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Curioso WH, Coronel-Chucos LG, Oscuvilca-Tapia E. Empowering the digital health workforce in Latin America in the context of the COVID-19 pandemic: the Peruvian case. Inform Health Soc Care 2024; 49:73-82. [PMID: 38349775 DOI: 10.1080/17538157.2024.2315266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The COVID-19 pandemic has exposed significant gaps in healthcare access, quality, and the urgent need for enhancing the capacity of digital health human resources, particularly in Latin America. During the pandemic, online courses and telehealth initiatives supported by governmental agencies, the Pan American Health Organization, and other public and private resources, have played a crucial role in meeting training demands. This article discusses the role of capacity building programs in digital health within the context of Latin America, with a specific focus on the Peruvian case. We highlight the development of digital health competencies and related policies, while also describing selected experiences related to capacity building in this field. Additionally, we discuss the pivotal role of collaborative partnerships among institutions and countries, emphasizing the importance of culturally relevant training programs in digital health. These initiatives have the potential to accelerate training and research opportunities in Latin America, drawing on the involvement of government agencies, non-governmental organizations, industry, universities, professional societies, and communities.
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Affiliation(s)
- Walter H Curioso
- Vicerrectorado de Investigación, Universidad Continental, Lima, Peru
| | | | - Elsa Oscuvilca-Tapia
- Facultad de Medicina Humana, Universidad Nacional José Faustino Sánchez Carrión, Huacho, Peru
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