How are household economic circumstances affected after a stroke? The psychosocial outcomes in StrokE (POISE) Study

Abstract

Background and Purpose-Stroke is associated with severe economic consequences. This is the first study to investigate in younger survivors the household economic burden of stroke. Methods-A multicenter, 3-year prospective cohort study was conducted of younger (18-65 years) survivors in Australia. Pre-and poststroke patterns of income and hardship were evaluated and multivariable logistic regression identified the predictors of economic hardship after stroke. Results-Four hundred fourteen participants were followed up over 12 months after stroke. The variables that independently predicted economic hardship after stroke were: female (OR, 2.94; 95% CI, 1.52-5.70), hazardous alcohol consumption (OR, 2.28; 95% CI, 1.00-5.20), manual occupation (OR, 1.88; 95% CI, 1.07-3.30), lack of health insurance (OR, 2.01; 95% CI, 1.12-3.60), and prior hardship (OR, 3.93; 95% CI, 2.12-7.29), whereas concessional status (OR, 0.50; 95% CI, 0.26-0.95) and more social contacts per week (OR, 0.99; 95% CI, 0.98-1.00) reduced hardship likelihood. Conclusions-Higher prestroke income did not buffer hardship after stroke nor did clinical, health service, or disability factors. Policies to reduce inequalities after stroke would be best aimed at socioeconomic targets.