Rationalisation of hospital services for stroke patients

Over a six month period, the Royal Melbourne Hospital admitted 25% of the stroke patients expected from the north-west region of Melbourne. When the private sector and Mount Royal Hospital were included, a total of 57% of expected demand was met by the hospital services of the region. The natural history of stroke in in hospital consisted of an early "active" phase with a high death rate and a high investigation rate. Three weeks after admission this activity had largely subsided and it is suggested that the acute general hospital was no longer providing the most appropriate care. Transfer of patients with stroke three weeks after admission to a lower cost care situation with more appropriate use of staff would enable the Royal Melbourne Hospital to meet the demand for hospitalisation from its region.