Early supported discharge services for stroke patients: a meta-analysis of individual patients' data

Abstract

Appropriately resourced ESD services provided for a selected group of stroke patients can reduce long-term dependency and admission to institutional care as well as shortening hospital stays.

Re-Justification for Reducing the Length of Hospital Stay Based on Community-Based Appraisal of Functional Recovery of Cerebrovascular Disease Patient

“…Thus, the present study might be validated once patients in other OECD coun- tries come to require longer LOS than expected. Numerous studies have focused on the effectiveness and efficiency of healthcare, and healthcare outcomes such as LOS, mortality, and disability were the most important parameters when comparing quality of stroke care [3,7,8]. However, few studies have determined the essential impact …”

“…Many factors have been debated to explain the variation in LOS by adjusting for patient characteristics such as age and stroke severity; treatment strategies or system organizations such as interdisciplinary care delivery; and hospital characteristics such as hospital volume [1,[5][6][7][8][9][10]. Before focusing on healthcare resource utilization, patient outcomes and quality of daily life should be also considered as priorities.…”

“…To enhance the efficiency of stroke care and eliminate healthcare costs, referral policies for rehabilitation facilities and home-based settings have been implemented, which force institutions to reduce hospitalization and to provide an effective strategy aimed at recovering the functional activity of daily life [7,9,11]. However, care-related health outcomes other than mortality and complications have not been sufficiently investigated to justify reducing LOS [1,5,12].…”

Stroke Unit Care Is Beneficial Both for the Patient and for the Health Service and Should Be Widely Implemented

“…Hence, SUs with a strong focus on both acute care and early rehabilitation and further follow-up of rehabilitation needs, including an early supported discharge service, provide the key components in evidence-based stroke service today. 1,13 It is of course necessary to adapt the organization of the stroke service to local traditions as well as variation in health care systems, but many of the key components should be present in all stroke services that want to be effective and evidencebased. The challenge is to implement these aspects of stroke service in the health service systems in different countries, and research like that from the study from Calgary 11 is important in this aspect.…”

Video-based Feedback for Assisting Physical Activity

“…Usually, the supervised therapy session is done within a short period of time mainly due to economical reasons. In order to support and maintain the rehabilitation of stroke survivors, continuous home based therapy systems are being investigated [Langhorne et al, 2005, Zhou and Hu, 2008, Sucar et al, 2010, Hondori et al, 2013, Mousavi Hondori and Khademi, 2014, Chaaraoui et al, 2012, Ofli et al, 2016. Having these systems at home and easily accessible, the patients keep a good level of motivation to do more exercise.…”