Randomised controlled trial to evaluate early discharge scheme for patients with stroke

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Stroke rehabilitation is crucial for patient recovery and functional independence.
• Optimizing hospital resource utilization is a key challenge in stroke care.
• Community-based rehabilitation models aim to bridge the gap between hospital and home care.

Purpose of the Study:

• To evaluate the clinical effectiveness of an early discharge policy for stroke patients utilizing a community-based rehabilitation team.
• To compare the outcomes of early discharge with community rehabilitation against conventional hospital and community care.

Main Methods:

• A randomized controlled trial was conducted involving 331 medically stable stroke patients.
• Patients were assigned to either specialist community rehabilitation (up to 3 months) or conventional care.
• Clinical outcomes were assessed using the Barthel score, motoricity index, and other functional and psychological measures at 12 months.

Main Results:

• No significant differences in clinical outcomes were observed between the early discharge/community rehabilitation group and the conventional care group at one year.
• The early discharge group experienced a significantly shorter length of hospital stay (12 vs. 18 days).
• Patients in the community therapy group reported increased satisfaction with hospital care, and those with impairments were more likely to receive treatment.

Conclusions:

• Early discharge combined with specialist community rehabilitation is a feasible and clinically effective strategy for stroke patients.
• This model of care is well-accepted by patients and offers significant reductions in hospital bed utilization.
• Community-based rehabilitation demonstrates potential for improving healthcare efficiency without compromising patient outcomes.