[Use of health services during the first year after stroke in community dwelling patients]

Stroke is the leading cause of disability in the elderly population, and inpatient rehabilitation is the most accepted method of providing rehabilitation to stroke survivors remaining with moderate to severe disability. It is also a major component of the large resources that this patient population demands. Since it is possible to develop alternatives to inpatient rehabilitation, it is important to make a long-term evaluation of its resource allocation, to enable comparison with the other alternatives.

To evaluate and classify the health services demanded during the first year after stroke by patients who had received inpatient rehabilitation.

A prospective follow-up of 75 consecutive stroke survivors who remained with moderate disability and were accepted for inpatient rehabilitation. Utilization of health services was recorded and evaluated considering the patients health status and success in returning to independent daily function.

Inpatient rehabilitation lasted about fifty days, started relatively early and enabled participants to regain an acceptable level of basic functional independence. During the year of follow-up, about half of the patients were hospitalized, with stroke related causes contributing significantly. Not all patients were followed up regularly by community health services, and most suffered significant handicap and depression.

This survey justifies the initial investment in inpatient rehabilitation for preparing stroke survivors to continue their lives at home. There is a need to improve continuity of services and to refine the methods of medical and psychosocial follow-up in the community.