Functional outcomes post-stroke: Evidence from private rehabilitation facilities in South Africa between 2006 and 2023.

Background: Effective rehabilitation is crucial for stroke survivors to regain functional independence and reduce the healthcare burden associated with disability and hospital readmission. Aim: To evaluate the functional outcomes in patients with stroke at private rehabilitation facilities between 2006 and 2023. Setting: This was a retrospective cohort study of 9010 patients, post-stroke, at private rehabilitation facilities registered with the South African Board of Healthcare Funders. Methods: The 7-point BETA scale was used to measure inpatients' ability to perform Activities of Daily Living (ADL) in real time. Secondary analysis was conducted on ADL data sets ( Results: Functional outcomes showed limited improvement; 40.8% of inpatients experienced deterioration, 19.5% showed no functional gain, 31.9% showed modest gain, and a small minority (< 0.5%) achieved substantial functional gains. Predictors of functional outcomes included age, gender, racial demographics, facility type and stroke characteristics. Conclusion: The findings indicate suboptimal functional outcomes in patients, post-stroke, at private rehabilitation facilities. There is a need for targeted improvements in rehabilitation practices and policy changes to enhance post-stroke functional outcomes. Contribution: This study provides longitudinal perspectives of patients' functional outcomes post-stroke in private rehabilitation facilities and an evidence base for informing rehabilitation practice improvements.