title: Towards a better integrated stroke care: the development of integrated stroke care in the southern part of the Netherlands during the last 15 years (Special 10th Anniversary Edition paper).
abstract: BACKGROUND
  Stroke care is complex and often provided by various healthcare organisations. Integrated care solutions are needed to optimise stroke care. In this paper, we describe the development of integrated stroke care in the region of Maastricht during the last 15 years.
  Located in the south of the Netherlands, the region of Maastricht developed integrated stroke care to serve a population of about 180,000 people. Integration was needed to improve the continuity, coordination and quality of stroke care. The development of integrated care in Maastricht was a phased process. The last phase emphasized early discharge from hospital and assessing the best individual rehabilitation track in a specialized nursing home setting.
  The development and implementation of integrated stroke care in the region of Maastricht led to fewer days in hospital, more patients being directly admitted to the stroke unit and an earlier start of rehabilitation. The implementation of early discharge from the hospital and rehabilitation assessment in a nursing home led to some unforeseen problems and lessons learned.
authors.affiliation: Vivre Group, Polvertorenstraat 6 6211 LX Maastricht, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: Heijnen
authors.forename: Martien
authors.initials: M
authors.lastname: Limburg
authors.forename: Silvia
authors.initials: S
authors.lastname: Evers
authors.forename: George
authors.initials: G
authors.lastname: Beusmans
authors.forename: Trudy
authors.initials: T
authors.lastname: van der Weijden
authors.forename: Jos
authors.initials: J
authors.lastname: Schols