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Healthcare resource utilization and clinical outcomes associated with acute care and inpatient rehabilitation of stroke patients in Japan
- Source :
- International journal for quality in health care : journal of the International Society for Quality in Health Care. 29(1)
- Publication Year :
- 2015
-
Abstract
- Objective To investigate healthcare resource utilization and changes in functional status in stroke patients during hospitalization in an acute hospital and a rehabilitation hospital. Design Retrospective cohort study. Setting One acute and one rehabilitation hospital in Japan. Participants Patients who were admitted to the acute hospital due to stroke onset and then transferred to the rehabilitation hospital ( n = 263, 56% male, age 70 ± 12 years). Main outcome measures Hospitalization costs and functional independence measure (FIM) were evaluated according to stroke subtype and severity of disability at discharge from the acute hospital. Results Median (IQR) costs at the acute hospital were dependent on the length of stay (LOS) and implementation of neurosurgery, which resulted in higher costs in subarachnoid hemorrhage [$52 413 ($49 166–$72 606) vs $14 129 ($11 169–$19 459) in cerebral infarction; and vs $15 035 ($10 920–$21 864) in intracerebral hemorrhage]. The costs at the rehabilitation hospital were dependent on LOS, and higher in patients with moderate disability than in those with mild disability [$30 026 ($18 419–$39 911) vs $18 052 ($10 631–$24 384)], while those with severe disability spent $25 476 ($13 340–$43 032). Patients with moderate disability gained the most benefits during hospitalization in the rehabilitation hospital, with a median (IQR) total FIM gain of 16 (5–24) points, compared with a modest improvement in patients with mild (6, 2–14) or severe disability (0, 0–5). Conclusions The costs for in-hospital stroke care were substantial and the improvement in functional status varied by severity of disability. Our findings would be valuable to organize efficient post-acute stroke care.
- Subjects :
- Rehabilitation hospital
Male
medicine.medical_specialty
medicine.medical_treatment
Rehabilitation Centers
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Japan
Acute care
Outcome Assessment, Health Care
Medicine
Humans
030212 general & internal medicine
Stroke
health care economics and organizations
Aged
Retrospective Studies
Intracerebral hemorrhage
Aged, 80 and over
Inpatients
Rehabilitation
business.industry
Cerebral infarction
Health Policy
Public Health, Environmental and Occupational Health
Stroke Rehabilitation
Retrospective cohort study
General Medicine
Recovery of Function
Length of Stay
Middle Aged
medicine.disease
Functional Independence Measure
Hospitalization
Physical therapy
Female
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14643677
- Volume :
- 29
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- International journal for quality in health care : journal of the International Society for Quality in Health Care
- Accession number :
- edsair.doi.dedup.....bba00087610a9d26e81dba9db90ea86a