Facilitating recovery: evidence for organized stroke care.
Despite dramatic advances in the management of thrombolysis and acute stroke, organized rehabilitation remains the cornerstone of recovery from stroke. The importance of organized stroke care in facilitating recovery has been recognized for the last 10 years, but it is still unclear how organized rehabilitation contributes to improved outcomes. This paper presents a synthesis of evidence of the benefits of organized care, especially with respect to stroke severity and different types of organized stroke care. It presents an overview of possible processes within organized rehabilitation that may contribute to good outcomes. The role of integrated care pathways within rehabilitation settings is discussed, highlighting the limitations of current evidence and uncertainty about their benefits. Finally, some key challenges have been identified for stroke units in improving rehabilitation outcomes over the next decade and for healthcare planners in investing adequately in organized stroke services.
Kalra
Lalit
L
Department of Stroke Medicine, King's College London School of Medicine, London, UK. lalit.kalra@kcl.ac.uk
Langhorne
Peter
P
D019091:Critical Pathways; D019317:Evidence-Based Medicine; D006757:Hospital Units / Q000191:economics / Q000458:organization & administration; D006801:Humans; D010347:Patient Care Planning; D019057:Quality-Adjusted Life Years; D020127:Recovery of Function; D012046:Rehabilitation / Q000191:economics / Q000458:organization & administration*; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome