Early Supported Discharge for Stroke Patients Improves Clinical Outcome. Does It Also Reduce Use of Health Services and Costs?Fjaertoft H. · Indredavik B. · Magnussen J. · Johnsen R.
Department of Public Health and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Background: An early supported discharge service (ESD) appears to be a promising alternative to conventional care. The aim of this trial was to compare the use of health services and costs with traditional stroke care during a one-year follow-up. Methods: Three hundred and twenty patients were randomly allocated either to ordinary stroke unit care or stroke unit care combined with ESD which was coordinated by a mobile team. The use of all health services was recorded prospectively; its costs were measured as service costs and represent a combination of calculated average costs and tariffs. Hospital expenses were measured as costs per inpatient day and adjusted for the DRG. Results: There was a reduction in average number of inpatient days at 52 weeks in favour of the ESD group (p = 0.012), and a non-significant reduction in total mean service costs in the ESD group (EUR 18,937/EUR 21,824). ESD service seems to be most cost-effective for patients with a moderate stroke. Conclusion: Acute stroke unit care combined with an ESD programme may reduce the length of institutional stay without increasing the costs of outpatient rehabilitation compared with traditional stroke care.
© 2005 S. Karger AG, Basel
Received: October 27, 2004
Accepted: January 7, 2005
Published online: April 28, 2005
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 5, Number of References : 21
Vol. 19, No. 6, Year 2005 (Cover Date: Released June 2005)
Journal Editor: Bogousslavsky, J. (Lausanne)
ISSN: 1015–9770 (print), 1421–9786 (Online)
For additional information: http://www.karger.com/ced