Effectiveness of Stroke Early Supported Discharge: Analysis From a National Stroke Registry.

Circulation. Cardiovascular Quality and Outcomes
Rebecca J FisherMarion F Walker

Abstract

Implementation of stroke early supported discharge (ESD) services has been recommended in many countries' clinical guidelines, based on clinical trial evidence. This is the first observational study to investigate the effectiveness of ESD service models operating in real-world conditions, at scale. Using historical prospective data from the United Kingdom Sentinel Stroke National Audit Programme (January 1, 2016-December 31, 2016), measures of ESD effectiveness were "days to ESD" (number of days from hospital discharge to first ESD contact; n=6222), "rehabilitation intensity" (total number of treatment days/total days with ESD; n=5891), and stroke survivor outcome (modified Rankin scale at ESD discharge; n=6222). ESD service models (derived from Sentinel Stroke National Audit Programme postacute organizational audit data) were categorized with a 17-item score, reflecting adoption of ESD consensus core components (evidence-based criteria). Multilevel modeling analysis was undertaken as patients were clustered within ESD teams across the Midlands, East, and North of England (n=31). A variety of ESD service models had been adopted, as reflected by variability in the ESD consensus score. Controlling for patient characteristics and ...Continue Reading

References

Jun 20, 2008·Health & Social Care in the Community·Annette Swinkels, Theresa Mitchell
Mar 29, 2011·Stroke; a Journal of Cerebral Circulation·Rebecca J FisherMarion F Walker
May 17, 2011·Lancet·Peter LanghorneGert Kwakkel
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Feb 14, 2015·Stroke; a Journal of Cerebral Circulation·Melanie TurnerUNKNOWN Scottish Stroke Care Audit
Apr 2, 2015·Clinical Rehabilitation·Rebecca J FisherMarion F Walker
Jan 15, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Dominique A CadilhacAtte Meretoja
Mar 24, 2016·Journal of the Neurological Sciences·Julius KoifmanMoira K Kapral
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May 21, 2019·Stroke; a Journal of Cerebral Circulation·Opeolu AdeoyeEdward C Jauch

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Citations

Oct 8, 2021·Disability and Rehabilitation·Adrian ByrneRebecca J Fisher

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