title: [Beds dedicated to stroke patients in postacute care units. Are national guidelines followed?].
abstract: OBJECTIVE
  We sought to determine the number of beds necessary for stroke patients in postacute care units and to measure the relevance of the national guidelines on required number of beds.
  
  
  METHODS
  We conducted an epidemiological follow-up of a cohort, what allowed for evaluating stroke care under real-life conditions. We applied the French guidelines for transfer of patients to postacute care wards.
  
  
  RESULTS
  Of the 605 stroke patients hospitalised, 156 with a mean age of 72 years were included. A total of 64 (41%) could return home directly from the acute care wards and 73 (47%) were referred to postacute care wards. Among the latter patients, 31 (43%) were transferred to a physical medicine and rehabilitation (PMR) unit and 42 (57%) to a geriatric unit. The 19 remaining patients died in acute care. Of the 137 surviving patients, 46.7% returned directly home and 53.2% were referred to postacute care wards. Of patients older than 80 years, 74% were transferred to a geriatric unit, whereas 76% of the patients less than 80 years were transferred to a PMR unit.
  
  
  CONCLUSIONS
  The national guidelines are based on a rate of discharge of about 24% of stroke patients to postacute care wards. In our study, we found that 47% were transferred to such wards. If the guidelines are applied, 19 beds dedicated to stroke patients would be necessary for postacute stroke care on a national level, or double that (36) on a regional level. Of these 36 beds, 16 to 24 should be PMR beds. The calculation of the number of beds necessary often rests on a simple transposition of the results of the studies and not on an objective evaluation according to the local context. Studies of longitudinal follow-up of cohorts such as this seem essential to evaluate needs and measure the relevance of the national guidelines.
authors.affiliation: Département de médecine physique et de réadaptation, CHU, hôpital J.-Rebeyrol, 87042 Limoges, France. davietjc@aol.com
authors.forename: J-C
authors.initials: JC
authors.lastname: Daviet
authors.forename: F
authors.initials: F
authors.lastname: Quet
authors.forename: A
authors.initials: A
authors.lastname: Stuit
authors.forename: C
authors.initials: C
authors.lastname: Verdié-Kessler
authors.forename: C Nguyen
authors.initials: CN
authors.lastname: Hoang
authors.forename: J-Y
authors.initials: JY
authors.lastname: Salle
authors.forename: P
authors.initials: P
authors.lastname: Dudognon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003266:Continuity of Patient Care; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D010351:Patient Discharge; D012047:Rehabilitation Centers; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation