Early Supported Discharge and Continued Rehabilitation at Home After Stroke: 5-Year Follow-up of Resource Use

Background: Early supported discharge (ESD) with continued rehabilitation at home has shown a beneficial effect on extended activities of daily living 5 years after stroke. The long-term effect of ESD on resource use has not been explored. Methods: At 5 years, 54 patients with mild to moderate disability, enrolled in a randomized controlled trial of ESD, were followed up. Data were collected from a county register and by interviewing the patient or the patient’s spouse. Results: There were differences in mean length of hospitalization, 51 versus 32 days (P = .02). There was no significant difference between the groups in regard to total outpatient rehabilitation, ESD visits included, but there was a difference in where the services were obtained. The ESD group had more rehabilitation at home (ESD service) and the control group had more outpatient rehabilitation (P = .04), including physiotherapy in primary care (P = .05). There were no other differences. Conclusion: We conclude that, 5 years after stroke, our ESD service was favorable with regard to resource use.

Key Words:  Stroke , organized stroke care , health resources , randomized controlled trial , rehabilitation