Background Disadvantaged socioeconomic status is associated with higher stroke incidence
and mortality, and higher readmission rate. We aimed to assess the effect of socioeconomic
factors on case fatality, health related quality of life (HRQoL), and satisfaction
with care of stroke survivors in the framework of the European Health Care Outcomes,
Performance and Efficiency (EuroHOPE) study in Hungary, one of the leading countries
regarding stroke mortality. Methods We evaluated 200 consecutive patients admitted
for first-ever ischemic stroke in a single center and performed a follow-up at 3 months
after stroke. We recorded pre- and post-stroke socioeconomic factors, and assessed
case fatality, HRQoL and patient satisfaction with the care received. Stroke severity
at onset was scored by the National Institutes of Health Stroke scale (NIHSS), disability
at discharge from acute care was evaluated by the modified Rankin Score (mRS). To
evaluate HRQoL and patient satisfaction with care we used the EQ-5D-5L, 15D and EORTC
IN PATSAT 32 questionnaires. Results At 3 months after stroke the odds of death was
significantly increased by stroke severity (NIHSS, OR = 1.209, 95%CI: 1.125–1.299,
p<0.001) and age (OR = 1.045, 95%CI: 1.003–1.089, p = 0.038). In a multiple linear
regression model, independent predictors of HRQoL were age, disability at discharge,
satisfaction with care, type of social dwelling after stroke, length of acute hospital
stay and rehospitalization. Satisfaction with care was influenced negatively by stroke
severity (Coef. = -1.111, 95%C.I.: -2.159- -0.062, p = 0.040), and positively by having
had thrombolysis (Coef. = 25.635, 95%C.I.: 5.212–46.058, p = 0.016) and better HRQoL
(Coef. = 22.858, 95%C.I.: 6.007–39.708, p = 0.009). Conclusion In addition to age,
disability, and satisfaction with care, length of hospital stay and type of social
dwelling after stroke also predicted HRQoL. Long-term outcome after stroke could be
improved by reducing time spent in hospital, i.e. by developing home care rehabilitation
facilities thus reducing the need for readmission to inpatient care.
