Randomized controlled trial of rehabilitation at home after stroke: one-year follow-up of patient outcome, resource use and cost. Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] Journal article | | Title | Randomized controlled trial of rehabilitation at home after stroke: one-year follow-up of patient outcome, resource use and cost. | | Author(s) | von Koch L, de Pedro-Cuesta J, Kostulas V, Almazán J, Widén Holmqvist L | | Institution | Unit of Neuroepidemiology and Health Service Research, Division of Neurology, Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden. lenkoc@ki.se | | Source | Cerebrovasc Dis 2001 Aug; 12(2):131-8. | | MeSH | Aged
Cerebrovascular Accident
Female
Follow-Up Studies
Health Care Costs
Health Resources
Home Care Services
Humans
Length of Stay
Male
Outcome Assessment (Health Care)
Patient Discharge
Research Support, Non-U.S. Gov't
Time Factors
| | Abstract | BACKGROUND AND PURPOSE: This study sought to evaluate early supported discharge and continued rehabilitation at home after stroke, at a minimum of 6 months after the intervention, in terms of patient outcome, resource use and health care cost.
METHODS: Eighty-three patients, moderately impaired 5-7 days after acute stroke, were included in a randomized controlled trial, 42 being allocated to the intervention and 41 to routine rehabilitation. One-year follow-up of patient outcome included mortality, motor capacity, dysphasia, activities of daily living, social activities, perceived dysfunction, and self-reported falls. Resource use over 12 months included inpatient hospital care, outpatient health care, use of health-related services, informal care, and cost of health care.
RESULTS: On univariate analysis there was no difference in patient outcome. Multivariate regression analysis showed that intervention had a significant effect on independence in activities of daily living. A significant difference in inpatient hospital care, initial and recurrent, was observed, with a mean of 18 (intervention) versus 33 days (control) (p = 0.002). Further significant differences were that the control group registered more outpatient visits to hospital occupational therapists (p = 0.02), private physical therapists (p = 0.03) and day-hospital attendance (p = <0.001), while the intervention group registered more visits to nurses in primary care (p = 0.03) and home rehabilitation (p = <0.001). Other differences in outcomes or resource utilization were nonsignificant.
CONCLUSION: In Sweden, early supported discharge with continued rehabilitation at home proved no less beneficial as a rehabilitation service, and provided care and rehabilitation for 5 moderately disabled stroke patients over 12 months after stroke onset for the cost of 4 in routine rehabilitation. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Randomized Controlled Trial
| | PubMed ID | 11490107 |
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