{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T20:15:32Z","timestamp":1778530532272,"version":"3.51.4"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR202339"],"award-info":[{"award-number":["NIHR202339"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Applied Research Collaboration (ARC) South London at King\u2019s College Hospital NHS Foundation Trust"},{"name":"NIHR or the Department of Health and Social Care"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Policy shifts towards home-based care are reshaping the management of stroke survivors, many of whom require long-term support. Home care, which encompasses social care for personal and household tasks and informal care provided by family and friends, plays a crucial role in post-stroke recovery and community reintegration. This study examined home care use up to 15\u00a0years post-stroke and its associated factors, and assessed unmet needs for assistance with activities of daily living (ADLs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Data from 7885 stroke survivors in the South London Stroke Register (1995\u20132022) were analysed at 3\u00a0months, 1, 5 and 15\u00a0years post-stroke. Descriptive analyses examined home care patterns and unmet needs. A Heckman selection model assessed factors associated with home care use while accounting for missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On average, 75% of stroke survivors used home care across 15\u00a0years post-stroke, with 83% of care at 3\u00a0months and 87% at 15\u00a0years being provided through informal care. Home care use was more likely among those with functional dependency (29%; 95% CI, 22%\u201335%) and those living with family (24%; 95% CI, 21%\u201327%). Social care use was higher in people with greater dependency (48%; 95% CI, 42%\u201356%), those living alone (25%; 95% CI, 21%\u201329%), those with lower deprivation (10%; 95% CI, 1%\u201320%) or those with a Black ethnic background (6%; 95% CI, 2%\u20139%). Informal care use was higher among those living with family (12%; 95% CI, 9%\u201314%), those with moderate dependency (2%; 95% CI, 0.1%\u20135%) or females (6%; 95% CI, 3%\u20139%). Unmet needs in ADLs increased over time (12% at 3\u00a0months to 17% at 15\u00a0years) and were higher among those with moderate compared with severe functional dependency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Within home care, informal care remains the predominant long-term support for stroke survivors, persisting up to 15\u00a0years after stroke. Addressing health-related, socio-economic, ethnic and gender disparities in home care and unmet needs is essential for equitable community-based stroke care, and caution is needed when promoting home-based care models regarding the distributional impact of home care. Accurate measurement of home care is key to improving post-stroke care models and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/aakag045","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T19:51:21Z","timestamp":1778529081000},"source":"Crossref","is-referenced-by-count":0,"title":["Variation in stroke survivors\u2019 long-term home care use: a South London population-based study"],"prefix":"10.1093","volume":"11","author":[{"given":"Wasana","family":"Kalansooriya","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences, King\u2019s College London , London ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2594-2654","authenticated-orcid":false,"given":"Iain J","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, King\u2019s College London , London 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