Early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic: a comparison of three stroke units
Abstract
Quality of life and costs related to stroke survivors are important issues for the Czech healthcare system. Early rehabilitation after stroke has a great potential to improve patients' quality of life as well as to contribute to saving long-term societal costs.
A tri-centre pragmatic longitudinal study was focused on the economic analysis of early rehabilitation after stroke in hospitals in the Czech Republic. The research also revealed dissimilarities in procedures between the involved hospitals.
The number of patients included in the study was 87 (Prague - 29, Ústí nad Labem - 31, Ostrava - 27). All of them were admitted to the early rehabilitation unit less than 70 days after stroke.
Data were collected using the bottom-up method alongside the standard patient care. The inter-hospital differences manifested themselves mainly in the severity of the patients transferred from neurology to early rehabilitation wards, length of the hospitalization, average cost of the hospital stay, and to some degree also in the clinical outcomes (represented by the FIM scores).
The analysis showed improvements in clinical outcomes in all groups and all hospitals. The differences in the costs of the hospitalization were caused predominantly by hospitalization length.
The differences in the average one-day costs were caused only by particular hospitals' treatment procedures and operational processes.