title: Use of time by stroke patients: a comparison of four European rehabilitation centers.
abstract: OBJECTIVE
  Differences exist between European countries in the proportion of patients who die or become dependent after stroke. The aim of the present study was to identify differences in the use of time by stroke patients in 4 rehabilitation centers in 4 European countries.
  
  
  METHODS
  In each of the 4 centers, 60 randomly selected stroke patients were observed at 10-minute intervals using behavioral mapping. Observations took place on 30 weekdays selected at random, on equal numbers of morning, afternoon, and evening sessions. A logistic generalized estimating equation model with correction for differences in case mix and multiple testing was used for the analysis.
  
  
  RESULTS
  Overall time available from different professions was the highest in the United Kingdom, but patients in the United Kingdom spent on average only 1 hour per day in therapy. This was significantly less than patients in Belgium and Germany, who spent approximately 2 hours, and patients in Switzerland who spent approximately 3 hours per day in therapy. In all centers, patients spent less than half their time in interactions and >72% of the time in nontherapeutic activities.
  
  
  CONCLUSIONS
  Important differences in the use of time were established, which appeared dependent on management decisions rather than the number of staff available. Patients in the Swiss and German centers spent more time in therapy, possibly because of the structured organization of rehabilitation. Further studies will verify whether this has an effect on outcome.
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium. Liesbet.Dewit@faber.kuleuven.be
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Wit
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
authors.forename: Ilse
authors.initials: I
authors.lastname: Baert
authors.forename: Peter
authors.initials: P
authors.lastname: Berman
authors.forename: Kris
authors.initials: K
authors.lastname: Bogaerts
authors.forename: Nadine
authors.initials: N
authors.lastname: Brinkmann
authors.forename: Louise
authors.initials: L
authors.lastname: Connell
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Walter
authors.initials: W
authors.lastname: Jenni
authors.forename: Christiane
authors.initials: C
authors.lastname: Kaske
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lesaffre
authors.forename: Mark
authors.initials: M
authors.lastname: Leys
authors.forename: Nadina
authors.initials: N
authors.lastname: Lincoln
authors.forename: Fred
authors.initials: F
authors.lastname: Louckx
authors.forename: Birgit
authors.initials: B
authors.lastname: Schuback
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schupp
authors.forename: Bozena
authors.initials: B
authors.lastname: Smith
authors.forename: Willy
authors.initials: W
authors.lastname: De Weerdt
mesh_terms: D000203:Activities of Daily Living; D001519:Behavior; D001530:Belgium; D002561:Cerebrovascular Disorders / Q000628:therapy; D004185:Disability Evaluation; D005060:Europe; D005858:Germany; D006801:Humans; D007902:Length of Stay; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D012046:Rehabilitation / Q000379:methods*; D012047:Rehabilitation Centers; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation; D013557:Switzerland; D013995:Time; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom; D000078329:Workforce