A retrospective review of speech-language therapy services provided to adult inpatients at a central-level hospital in Gauteng, South Africa.
Jennifer Stone, Azra Hoosen, Hayley Hochfelden and 2 others
PMID 33314954WHAT IT FOUND
Swallowing disorder was the most common speech-language problem among 2549 adult hospital inpatients who received speech-language therapy, followed by aphasia and dysarthria. 44.68% had more than one speech-language diagnosis, and 39.98% required further treatment after discharge.
Key findings
01In 2549 adult inpatients receiving speech-language therapy, swallowing disorder was the most common diagnosis (1248; 48.96%), followed by aphasia (789; 30.95%) and dysarthria (602; 23.62%), and 1139 (44.68%) had multiple co-existing speech-language diagnoses.
02Cerebrovascular disease was the most frequent medical condition (1337; 52.45%), and among those patients 117 were aged 18 to 25 years, 369 were 26 to 55 years, and 851 were older than 56 years.
03A total of 1019 patients (39.98%) required further treatment after hospital discharge, including 693 patients with cerebrovascular disease (51.83%) and 166 patients with traumatic brain injury (52.37%).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study describes one public hospital's records over two years, so it may not represent other settings. It is a retrospective record review, not a trial, so it cannot show whether any speech-language therapy intervention improved outcomes. The hospital protocol required speech-language therapists to see all referrals, so some patients may have been recorded even when services were not appropriate or when function was intact. HIV status was unknown for 45.43% of patients, so the study could not make a conclusive link between HIV and cerebrovascular disease. Inter-rater agreement was only moderate for some recorded variables, and medical conditions may have been coded inconsistently when moved into the database. The data do not say what specific services were provided for patients recommended for monitoring.
The easy way to misread this
Do not read these service patterns as evidence that any particular speech-language therapy intervention improves recovery. The paper describes records of referrals, diagnoses, recommendations and end-of-service status, not a comparison of treatments.