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A review of early supported discharge after stroke

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  31 August 2010

Linda Brewer  and
David Williams
Linda Brewer*
Affiliation:
Department of Geriatric Medicine, Beaumont Hospital, Dublin 9, Ireland
David Williams
Affiliation:
Department of Geriatric Medicine, Beaumont Hospital, Dublin 9, Ireland Royal College of Surgeons in Ireland, Dublin 2, Ireland
*
Address for correspondence: lindabrewer@physicians.ie
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Summary

Stroke is a leading cause of disability worldwide and patients with stroke frequently require prolonged periods of in-patient rehabilitation prior to discharge. This poses a large economic strain on health services, and the cost-effectiveness of this system has been questioned. However, in implementing changes in the delivery of post-acute stroke care it is important that patient outcome is not compromised. Early supported discharge (ESD) was introduced approximately 15 years ago and allows suitable patients to be discharged home early with increased support from a well co-ordinated, multi-disciplinary rehabilitation team in the patient's own home. This paper focuses upon the evidence available from multiple international studies of ESD over the last decade, including both clinical benefit and cost-effectiveness. Findings from these trials are largely positive resulting from a reduction in bed days, therefore overall cost, and an improvement in function and independence reported in many studies. Suitable patient selection, careful discharge planning and continuity of care by the ESD linked to a stroke unit are essential components of the success of this service.

Keywords

strokerehabilitationearly supported discharge
Type
Intermediate care and rehabilitation
Information
Reviews in Clinical Gerontology , Volume 20 , Issue 4 , November 2010 , pp. 327 - 337
Copyright
Copyright © Cambridge University Press 2010

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