[Quality of primary medical care after in-patient stroke rehabilitation].
OBJECTIVE
Since only insufficient information concerning the further development of patients after stroke and rehabilitation is currently available, and since the quality of care provided by family doctors is often classified as insufficient, this quality of care was to be examined on the basis of the rehabilitation results. Of particular interest were the co-operation, the therapeutical quality standards and the risk management, as well as the quality of life and compliance of the patients.


METHODS
In 2000, all 223 stroke patients were asked prior to their discharge from three large rehabilitation clinics in North Baden, and subsequently their 210 family doctors, whether they were prepared to participate in this follow-up study. The participating patients were examined at their discharge from the clinic as well as 6 and 18 months later using a standardised documentation package, and quality circles for family doctors were initiated.


RESULTS
All patients with atrial fibrillation were treated to prevent thrombosis. Smoking showed a positive trend. Quality of life and knowledge of the sickness trend to increase, depressiveness decreases. 60 % of the contacted family doctors participated in the study, 29 % (33 out of 114 physicians at the end of the study) contributed to improve interdisciplinary co-operation. Although 87 % of the patients said to be well informed, 25 % were dissatisfied with their own compliance.


CONCLUSIONS
The quality of care of stroke patients by family doctors as assessed by indicators for secondary prevention and quality of life is satisfactory under present conditions. Apart from the hypertension control there was no negative trend. However, participation of GPs was insufficient. Co-operative after-care by GP can relatively easily stabilise health conditions following inpatient rehabilitation.
Wiesemann
A
A
Sektion Allgemeinmedizin & Versorgungsforschung der Universität Heidelberg. Armin.Wiesemann@t-online.de
Engeser
P
P
Reichert
K
K
Mollien
P
P
Schach
S
S
Scheidt
R
R
D001281:Atrial Fibrillation / Q000453:epidemiology; D015992:Body Mass Index; D003627:Data Interpretation, Statistical; D003863:Depression / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D011320:Primary Health Care; D011787:Quality of Health Care; D011788:Quality of Life; D012907:Smoking; D000071939:Stroke Rehabilitation; D013997:Time Factors