New horizons in stroke rehabilitation research

Helen Hoenig*, Ronnie D. Horner, Pamela W. Duncan, Elizabeth Clipp, Byron Hamilton

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    26 Citations (Scopus)


    To promote health services research in stroke rehabilitation, we gathered information about stroke rehabilitation structures, processes, and outcomes (SPO), using extant databases and the Donabedian theoretical model of health services evaluation. We found that, in the United States, over $3.6 billion was spent by third-party payers in 1992 on rehabilitation, including stroke. Total disability-related costs now amount to over $170 billion per year. However, there are few studies identifying cost-effective stroke rehabilitation practices. Existing studies indicate that the organizational structure of rehabilitation influences stroke outcomes, but it is less clear exactly what organizational practices constitute optimal stroke rehabilitation. Data about specific, beneficial rehabilitation processes are scanty for stroke. There are a number of valid and reliable outcome measures pertinent to stroke rehabilitation health services research. We conclude that health services research in stroke rehabilitation is sparse. To be more informative, rehabilitation health services research should be guided by the SPO model.

    Original languageEnglish
    Pages (from-to)19-31
    Number of pages13
    JournalJournal of rehabilitation research and development
    Issue number1
    Publication statusPublished - Jan 1999


    • Conceptual model
    • Health services research
    • Physical therapy
    • Rehabilitation
    • Structure and process of care


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