Long-term effects of the intensification of the transition between inpatient neurological rehabilitation and home care of stroke patients.
OBJECTIVE
To investigate an intensified transition concept between neurological inpatient rehabilitation and home care for long-term effects on the care situation two and a half years after stroke patients' discharge.


METHODS
Controlled clinical trial allocating patients to intervention group (intensified transition on ward II) or control group (standard transition on ward I); patients were allocated to whichever ward had a vacancy. The last follow-up assessment was carried out on average 31 months after discharge.


METHODS
The intensified transition concept consisted of therapeutic weekend care, bedside teaching and structured information for relatives during the second phase of the rehabilitation.


METHODS
Seventy-one patients and their family carers were included, of which one case dropped out. Therefore 70 family carers--35 individuals in each group-- were available for assessment at long-term follow-up.


METHODS
Family carers were asked via telephone whether the patient was still alive and if so, where he or she is living--at home or in a nursing home.


METHODS
Binary logistic regression analysis with the care situation (home care versus institutionalized care or deceased) as dependent variable.


RESULTS
Two and a half years after discharge (T3) in the intervention group significantly fewer patients were institutionalized (2 versus 5) or deceased (4 versus 11) (P = 0.010). Multivariate analysis showed that besides a higher functional life quality at discharge and lower patient's age, the participation in the intensified transition programme is the third significant predictor for home care at T3.


CONCLUSIONS
Effects of an intensified transition programme can persist over a long-term period. They can sustain home care by reducing institutionalization and mortality.
Gräsel
E
E
Clinic for Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Germany.
Schmidt
R
R
Biehler
J
J
Schupp
W
W
D000368:Aged; D017028:Caregivers / Q000193:education*; D005260:Female; D005500:Follow-Up Studies; D006701:Home Nursing; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010291:Paresis / Q000534:rehabilitation*; D010351:Patient Discharge; D026741:Physical Therapy Modalities / Q000193:education*; D000071939:Stroke Rehabilitation