A community study based on an age-stratified sample of those aged 55 y
ears and older in a northern health district in the United Kingdom has
been used to consider the implications for purchasing health-care ser
vices for those who have survived a stroke. The study showed that whil
e almost a quarter of those reporting a stroke had made a full recover
y, a pride range of impairments and disabilities persisted. Almost hal
f reported needing help at least daily. A logistic regression model to
predict this level of dependency found that impairments, disabilities
and other factors, such as locality, were also predictive of dependen
cy. A second model predicting mobility handicap (dwelling restricted)
was found to have a similar mix of predictors. These results show how
purchasers must consider the broad outcome in terms of a continuum of
impairment, disability and handicap. The results also show that handic
ap is a distinct concept that draws together many influences which act
upon the individual.