Patient outcomes and length of stay in a stroke unit offering both acute and rehabilitation services.
OBJECTIVE
To compare hospital length of stay (LOS) and outcome after stroke between patients in a stroke unit offering combined acute and rehabilitation services and patients treated elsewhere in New South Wales.


METHODS
Retrospective audit of two hospital databases (Diagnosis-Related Groups [DRG] database and Australian National Subacute Non-Acute Patient Classification System [AN-SNAP] database), with comparison with DRG and AN-SNAP data for NSW.


METHODS
242 episodes of acute stroke in patients admitted to the stroke unit of a metropolitan teaching hospital between July 1999 and November 2000, 113 of whom also underwent rehabilitation in the unit; 9777 episodes of acute stroke in the NSW DRG database, and 2350 in the NSW AN-SNAP database.


METHODS
Acute and rehabilitation LOS; mortality in acute care; FIM (Functional Independence Measure) score at discharge and change in FIM score; and discharge destination.


RESULTS
Patients in the combined stroke unit had shorter LOS and better functional outcome in all DRG and AN-SNAP groups, with both higher discharge FIM scores and greater gain in FIM scores than NSW patients. Acute stroke mortality of 12% and nursing home admission rate of 15.5% in the combined stroke unit were not significantly different from rates for NSW (15.7% and 11.2%, respectively).


CONCLUSIONS
Combining acute and rehabilitation services in a stroke unit may reduce LOS and improve functional outcome of patients with acute stroke.
Ang
Yan H
YH
Aged Care and Rehabilitation, Bankstown-Lidcombe Hospital, Sydney, NSW. Yan_Hoon_ANG@alexhosp.com.sg
Chan
Daniel K Y
DK
Heng
Derrick M K
DM
Shen
Qing
Q
D000208:Acute Disease; D000368:Aged; D003325:Coronary Care Units / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009517:New South Wales; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D020521:Stroke / Q000401:mortality / Q000628:therapy*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome