THE EFFECTIVENESS AND COSTS OF INTENSIVE STROKE REHABILITATION AND IMPROVEMENTS IN PATIENT PATHWAY IN FINLAND: A RETROSPECTIVE BENCHMARKING CONTROLLED TRIAL

The only goal in stroke is 100% recovery and you tell us NOTHING ABOUT THAT!

 THE EFFECTIVENESS AND COSTS OF INTENSIVE STROKE REHABILITATION AND IMPROVEMENTS IN PATIENT PATHWAY IN FINLAND: A RETROSPECTIVE BENCHMARKING CONTROLLED TRIAL

JRM Journal of Rehabilitation JRM Journal of Rehabilitation Medicine ORIGINAL REPORT 2024 ©Author(s). Published by MJS Publishing, on behalf of the Foundation for Rehabilitation Information. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).1 of 10 

Objective: 

To assess the effectiveness and costs of intensive stroke rehabilitation and improvements in patient pathway in the city of Lahti and in Päijät-Häme. 

Design:  

Retrospective benchmarking controlled trial. 

Three cohorts of Finnish community-dwelling patients (94,749, n4,184, and n105,458) with ischaemic stroke between 2001 and 2019.

Methods:

This study is based on the PERFECT 2001–2019 database of ischaemic stroke patients. PERFECT indicators describe how the stroke patients recover. The difference-in-difference method was used in the main analysis.

Results:

Improved rehabilitation in Lahti increased the share of patients discharged home p= 0.005) and decreased length of first institutional episode (–4 days,p=0.006), the share of patients institutionalized(–5.1%,p=0.001), the costs first episode(€–2,085,p<0.001) compared with the rest of Finland. Discharges to home increased 6.6 percentage points p=0.021) in Lahti compared with rest of Päijät-Häme. After 2013, the costs of first institutional episode per patient in Päijät-Häme decreased significantly compared with the rest of Finland (p<0.001).

Conclusion: 

Investments in intensive stroke rehabilitation and patient pathway seem to provide both

faster and better return to home(This doesn't mean 100% recovery, does it?)for patients and

reduced costs for the healthcare system.