Stroke rehabilitation in Fiji: are patients receiving services?

The national hospital and stroke rehabilitation services of the Fiji Ministry of Health.

To describe patients admitted with stroke to the Fiji Colonial War Memorial Hospital (CWMH) from January 2010 to December 2012, and to report on rehabilitation services accessed during and after admission.

Retrospective descriptive study using patient records.

Of the 328 patients admitted with stroke, 54% were male, 55% i-Taukei and 16% aged <50 years; 75% had hypertension, 41% diabetes and 37% both; 23% (n = 76) died. Of the survivors, 58% (146) received rehabilitation therapy during admission at the CWMH. After discharge, 10% (n = 26) received therapy at the National Rehabilitation Hospital; six accessed the services of the community rehabilitation assistants. Just over half of stroke survivors (52%) remained in CWMH for <1 week (median stay 6 days, IQR 4-11).

The length of stay and access to rehabilitation was inadequate for over half of the stroke survivors. After discharge, very few accessed the available rehabilitation services of the Ministry of Health. It will be crucial to review procedures for tracking patient use of rehabilitation services and to explore why patients are not accessing these services, which are vital to recovery and restoration of function.