Stroke rehabilitation – who benefits? A comparison of medical wards and rehabilitation units

Abstract

This prospective, multicentre, population study, of all first-stroke survivors in one year referred for in-patient rehabilitation, compares the efficiency and effectiveness of functional recovery following ad hoc and routine rehabilitation of general medical wards with intensive and comprehensive rehabilitation of mixed disability geriatric/rehabilitation units. After controlling for potential confounding variables, no significant differences were recorded in terms of Barthel discharge function scores, effectiveness or efficiency of rehabilitation. Conventional rehabilitation in general medical wards of acute hospitals was 35% more efficient than comprehensive rehabilitation in geriatric/rehabilitation units (1.08 vs. 0.70, P < 0.001), this being due to unnecessarily long rehabilitation stays (44 vs. 70 days, P < 0.000). Contrary to other studies, geriatric/rehabilitation units did not significantly increase the discharge scores, did not accelerate the process of rehabilitation, and did not decrease the demand for extended-care beds.