A multinational comparison of aphasia management practices

The effect of restructuring of healthcare on the quality, quantity, and nat ure of aphasia management is largely unknown. The current study is the firs t to examine access, diagnostic, treatment, and discharge patterns of patie nts with aphasia in Australia, Canada, the UK, the US private sector (US-Pr ivate), and the US Veterans Health Administration in the Department of Vete rans Affairs (US-VA). The authors developed a 37-item survey to be completed by clinicians workin g with aphasic patients. The survey focused on eight areas: access to care, evaluation procedures, group treatment, number and duration of treatment s essions, limitations of the number of sessions, termination of treatment, f ollow-up practices, and resumption of treatment. 394 surveys were distribut ed and 175 were returned completed (44% return rate). Respondents represent ed a range of ages, work experiences, and work settings. There was consider able consistency among respondents from our five healthcare systems. Result s suggest that patients may be routinely denied treatment in direct contrad iction to the research literature. Just as we carefully monitor the progres s of patients receiving our treatment, we are obliged to monitor the effect s of managed care on our patients, fellow clinicians, and our profession.