title: Can short-term residential care for stroke rehabilitation help to reduce the institutionalization of stroke survivors?
abstract: BACKGROUND
  Stroke survivors may not be receiving optimal rehabilitation as a result of a shortage of hospital resources, and many of them are institutionalized. A rehabilitation program provided in a short-term residential care setting may help to fill the service gap.
  
  
  OBJECTIVE
  The primary objectives of this study were, first, to examine whether there were significant differences in terms of rehabilitation outcomes at 1 year after admission to the rehabilitation program (defined as baseline) between those using short-term residential care (intervention group) and those using usual geriatric day hospital care (control group), and, second, to investigate whether lower 1-year institutionalization rates were observed in the intervention group than in the control group.
  
  
  METHODS
  155 stroke survivors who completed at least the first follow-up at 4 months after baseline.
  
  
  METHODS
  The intervention group was stroke survivors using self-financed short-term residential care for stroke rehabilitation. The control group was stroke survivors using the usual care at a public geriatric day hospital.
  
  
  METHODS
  Assessments were conducted by trained research assistants using structured questionnaires at baseline, 4 months, and 1 year after baseline. The primary outcome measures included Modified Barthel Index score, Mini-Mental Status Examination score, and the institutionalization rate.
  
  
  RESULTS
  Cognitive status (as measured by Mini-Mental Status Examination score) of patients in both groups could be maintained from 4 months to 1 year, whereas functional status (as measured by Modified Barthel Index score) of the patients could be further improved after 4 months up to 1 year. Meanwhile, insignificant between-group difference in rehabilitation outcomes was observed. The intervention participants had a significantly lower 1-year institutionalization rate (15.8%) than the control group (25.8%).
  
  
  CONCLUSIONS
  Short-term residential care for stroke rehabilitation promoted improvements in rehabilitation outcomes comparable with, if not better than, the usual care at geriatric day hospital. Furthermore, it had a significantly lower 1-year institutionalization rate. This type of service could be promoted to prevent institutionalization.
authors.affiliation: School of Nursing, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
authors.forename: Pui Hing
authors.initials: PH
authors.lastname: Chau
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
authors.forename: Maria W S
authors.initials: MW
authors.lastname: Tang
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
authors.forename: Fannie
authors.initials: F
authors.lastname: Yeung
authors.affiliation: School of Nursing, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
authors.forename: Tsz Wai
authors.initials: TW
authors.lastname: Chan
authors.affiliation: School of Nursing, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
authors.forename: Joanna O Y
authors.initials: JO
authors.lastname: Cheng
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D012112:Residential Facilities / Q000379:methods; D000071939:Stroke Rehabilitation; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
keywords: day hospital; institutionalization; rehabilitation; residential care; stroke