Is Stroke Early Supported Discharge still effective in practice? A prospective comparative study

Area of Science:

• Rehabilitation Medicine
• Neurology
• Health Services Research

Background:

• Randomized controlled trials confirm the benefits of Early Supported Discharge (ESD) for stroke survivors.
• The effectiveness of ESD in complex, frontline healthcare settings requires further evaluation.
• Understanding the impact of ESD on functional outcomes and caregiver well-being is crucial.

Purpose of the Study:

• To evaluate the continued benefits of Early Supported Discharge (ESD) for stroke survivors within a complex frontline healthcare system.
• To assess the impact of ESD on patient functional status, hospital length of stay, and satisfaction.
• To determine the effect of ESD on the mental health of caregivers.

Main Methods:

• A quasi-experimental cohort study design was employed.
• 293 stroke survivors were recruited from two acute stroke units into either an ESD group (n=135) or a Non-ESD group (n=158).
• Outcome measures, including the Barthel Index, were assessed at baseline, 6 weeks, 6 months, and 12 months.

Main Results:

• The ESD group experienced a significantly shorter hospital stay (P=0.029) and higher patient satisfaction (P<0.001).
• ESD participants showed significantly higher odds of achieving a Barthel Index score of 90+ at 6 weeks, 6 months, and 12 months post-adjustment.
• Caregivers of ESD patients reported significant improvements in mental health scores (P<0.01).

Conclusions:

• Early Supported Discharge (ESD) demonstrates sustained health benefits for stroke survivors, even when implemented in routine clinical practice.
• Evidence-based ESD models are effective in improving patient outcomes and caregiver well-being.
• ESD remains a valuable component of stroke care within complex healthcare environments.