Quality of care for completed stroke without rehabilitation: evaluation by assessing patient outcomes

Using the method of quality assurance of stroke rehabilitation developed at the University of Minnesota (UMn) by assessing patient outcomes on the basis of a modification of the Williamson Functional Limitation Scale (WFLS), 84 patients (group H) with completed stroke were surveyed 8 months to 13 years following treatment without rehabilitation at Hennepin County General Hospital. Because a greater percentage (42%) than estimated (29%) had died, the percentage of those not independent in self-care (31%) was less than estimated (46%). These patients were not matched with a group given rehabilitation (group U) previously studied at UMn but were generally less severely involved, although older on the average. However, even so, only 47% of those still living were independent in self-care in group H in contrast to 69% in group U. Also 42% of group H were in nursing homes or board-and-care facilities while only 18% of the rehabilitated group were. Although the modified WFLS is used in outcome studies for quality of rehabilitation, it is even sensitive enough to show differences in outcomes in a comparative study such as this.