Living With Stroke - Sustainable Utilization of Healthcare Services

NCT06096831 | Enrolling By Invitation

• 1 other identifier: CMC-0082-22
• Study Type: observational
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

The proposed study will generate a national mapping of healthcare utilization patterns in people post-stroke in the chronic phase living in the community; examine the associations between individual-level characteristics, health outcomes and healthcare utilization; and will describe patients' perspectives on their needs for health services and their experiences of using them. The study will use mixed-methods methodology (quantitative and qualitative) and will proceed in three parts. In part 1, data will be extracted retrospectively from electronic medical records of of Clalit Health Services, covering all patients with a stroke diagnosis. In part 2, a sub-sample of 240 patients will be asked to answer standardized questionnaires. In part 3, a sub-sample of 20 participants will participate in in-depth, semi-structured interviews.

Conditions

Stroke; Cerebrovascular Disorders; Cerebrovascular Accident; Healthcare Utilization

Keywords

Post-stroke; Healthcare utilization; Continuity of care; Rehabilitation

Outcome Measures

Primary Outcomes (4)

• Visits to a neurologist

  Monitoring the number of annual visits to a neurologist in the chronic phase of the disease. Extraction and analysis of data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.

  1 year

• Use of physical therapy services

  Monitoring the number of annual visits to physical therapy services in the chronic phase of the disease. Extraction and analysis of data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.

  1 year

• Stroke impact Scale - SIS 3.0

  The SIS-3.0 questionnaire evaluate how the stroke has impacted patients' health and life. It composed of 59 items investigating 8 domains (strength, hand function, mobility, activities of daily living, emotion, memory, communication, social participation) and also assesses the degree of recovery from the stroke. Range of scores is 0-100. Each item is scaling by a 5-point scale from 1 to 5. The questionnaire will be evaluated for a sub-sample of 250 patients.

  1 hour

• Visits to the emergency medicine center and urgent hospitalization data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.

  Monitoring the number of annual visits to the emergency medicine center and the number of urgent hospitalization in the chronic phase of the disease. Extraction and analysis of data from Clalit's electronic medical records (EMR) of all insured patients who had a stroke. An estimated number of 40,000 patients post-stroke.

  1 year

Secondary Outcomes (3)

• Use of occupational therapy services

  1 year

• Use of speech-language therapy services

  1 year

• Recurrent stroke

  1 year

Study Arms (1)

Post-Stroke patients at chronic phase living in the community

The data will be extracted from medical records of all people who are at least one year after a stroke, live in the community and are insured by Health maintenence Organization (HMO).In the first part we expect to extract data of approximately 40,000 patients . In the second part, a sub sample of 240 patients will be recruited to answer standardized questionnaires. In the third part, a sub-sample from part 2, of 20 people will be interviewed.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Post-stroke patients living in the community. At least one year after the stroke occurred. An estimated number of approximately 40,000 patients nationwide (Part 1) and 240 patients hospitalized at the 'Carmel' Medical Center (Part 2\&3).

You may qualify if:

• People diagnosed with stroke (First stroke occurred between 2010-2022)
• At least one year after the event
• Living in the community
• Aged 18 and above
• Insured by HMO (Clalit health services)

You may not qualify if:

• Stroke chronicity of less than a year
• Diagnosis of TIA (Transient Ischemic Attack)
• People diagnosed with stroke
• Hospitalized for a first stroke at the 'Carmel' Medical Center between 2010-2022
• Understand Hebrew/ Arabic/ Russian in a way that allows them to understand the consent form and answer the survey questions.
• Stroke chronicity of less than a year the study
• Transient ischemic attack (TIA)
• Patients who have a guardian, a nursing condition as a result of diseases other than stroke or other serious background diseases that impair function, people with communication difficulties that do not allow answering questionnaires or to be interviewed.

Sponsors & Collaborators

• University of Haifa: lead
• Ben-Gurion University of the Negev: collaborator
• Clalit Health Services: collaborator
• Carmel Medical Center: collaborator

Study Sites (1)

University of Haifa

Haifa, 3498838, Israel

Location

MeSH Terms

Conditions

Stroke; Cerebrovascular Disorders

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Michal Kafri, PhD

  University of Haifa

  PRINCIPAL INVESTIGATOR

• Sivan Bloch, M.D

  Carmel Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 8, 2023
• First Posted: October 24, 2023
• Study Start: November 15, 2023
• Primary Completion: March 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: December 16, 2025

Record last verified: 2025-10

Locations

IL (1)