Rehabilitation after stroke: changes between 2002 and 2007 in services provided by district health boards in New Zealand.
OBJECTIVE
To determine changes between 2002 and 2007 in stroke rehabilitation services provided by district health boards (DHBs) in New Zealand (NZ).


METHODS
A questionnaire about organisation of stroke rehabilitation services and use of recommended guidelines was sent to hospitals in all 21 DHBs.


RESULTS
Seven DHBs serving 49% of the NZ population provided a designated inpatient area for stroke rehabilitation in 2007 compared with one DHB serving 10% of the population in 2002 (p<0.001). In six DHBs (37%), this designated area was within a general rehabilitation unit. Only one DHB (12%) had a dedicated stroke rehabilitation unit. DHBs with a designated stroke rehabilitation area (SRA) were more likely to have multidisciplinary teams that spent more than half of the time with stroke patients (94% population with SRA versus 22% without SRA; p<0.001), audit their services (90% vs 39%; p<0.001), and provide education sessions for patients/families (82% vs 55%; p 0.004). However, many DHBs did not have guidelines for the management of common aspects of stroke care.


CONCLUSIONS
Stroke rehabilitation services have improved since 2002 but concerns exist about the variability and quality of services provided. A consistent national approach to implementation of guideline recommendations and audit of services is required.
Gommans
John
J
Hawke's Bay Hospital, Private Bag 9014, Hastings, New Zealand. john.gommans@hawkesbaydhb.govt.nz
Barber
P Alan
PA
Hanger
H Carl
HC
Bennett
Patricia
P
D003695:Delivery of Health Care / Q000639:trends*; D004185:Disability Evaluation; D005544:Forecasting; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D009313:National Health Programs / Q000639:trends*; D009520:New Zealand; D010348:Patient Care Team / Q000592:standards; D011787:Quality of Health Care / Q000639:trends; D012047:Rehabilitation Centers / Q000600:supply & distribution*; D000071939:Stroke Rehabilitation