+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Costs and caregiver consequences of early supported discharge for stroke patients



Costs and caregiver consequences of early supported discharge for stroke patients



Stroke 34(2): 528-536



Background and Purpose-Early supported discharge (ESD) for stroke has been shown to yield outcomes similar to or better than those of conventional care, but there is less information on the impact on costs and on the caregiver. The purpose of this study is to estimate the costs associated with an ESD program compared with those of usual care. Methods-We conducted a randomized controlled trial of stroke patients who required rehabilitation services and who had a caregiver at home. Results-Acute-care costs incurred before randomization when patients were medically ready for discharge averaged dollar sign3251 per person. The costs for the balance of the acute-care stay, from randomization to discharge, were dollar sign1383 for the home group and dollar sign2220 for the usual care group. The average cost of providing the 4-week home intervention service was dollar sign943 per person. The total cost generated by persons assigned to the home group averaged dollar sign7784 per person, significantly lower than the dollar sign11 065 per person for those assigned to usual care. A large proportion of the cost differential between the 2 groups arose from readmissions, for which the usual care group generated costs more than quadruple those of the home intervention group. Conclusions-Providing care at home was no more (or less) expensive for those with greater functional limitation than for those with less. Caregivers in the ESD group scored consistently lower on the Burden Index than caregivers with usual care, even caregivers of persons with major functional limitations. For persons recovering from stroke and their families, ESD provides a cost-effective alternative to usual care.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 010393530

Download citation: RISBibTeXText

PMID: 12574571

DOI: 10.1161/01.str.0000049767.14156.2c


Related references

Gothenburg very early supported discharge study (GOTVED) NCT01622205: a block randomized trial with superiority design of very early supported discharge for patients with stroke. Bmc Neurology 13: 66, 2013

Early Supported Discharge by Caregiver-Mediated Exercises and e-Health Support After Stroke: A Proof-of-Concept Trial. Stroke 47(7): 1885-1892, 2016

Early supported discharge after stroke in Bergen (ESD Stroke Bergen): three and six months results of a randomised controlled trial comparing two early supported discharge schemes with treatment as usual. Bmc Neurology 14: 239, 2014

Early supported discharge for stroke patients improves clinical outcome. Does it also reduce use of health services and costs? One-year follow-up of a randomized controlled trial. Cerebrovascular Diseases 19(6): 376-383, 2005

Caregiver-mediated exercises with e-health support for early supported discharge after stroke (CARE4STROKE): study protocol for a randomized controlled trial. Bmc Neurology 15: 193, 2015

Early supported discharge trialists. Early supported discharge after stroke (vol 39, pg 103, 2007). Journal of Rehabilitation Medicine 39(3): 269, 2007

Early supported discharge: a valuable alternative for some stroke patients. Lancet 365(9458): 455-456, 2005

Early supported discharge of patients with acute stroke: a randomized controlled trial. Disability and Rehabilitation 24(7): 348-355, 2002

Early home-supported discharge of stroke patients: a health technology assessment. International Journal of Technology Assessment in Health Care 22(3): 313-320, 2006

Early supported discharge services for stroke patients: a meta-analysis of individual patients' data. Lancet 365(9458): 501-506, 2005

A critical review of Early Supported Discharge for stroke patients: from evidence to implementation into practice. International Journal of Stroke 10(1): 7, 2015

Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial. Clinical Rehabilitation 31(2): 197-206, 2017

Early supported discharge after stroke in Bergen (ESD Stroke Bergen): a randomized controlled trial comparing rehabilitation in a day unit or in the patients' homes with conventional treatment. International Journal of Stroke 8(7): 582-587, 2013

A qualitative study exploring patients' and carers' experiences of Early Supported Discharge services after stroke. Clinical Rehabilitation 27(8): 750-757, 2013

Early supported discharge following mild stroke: a qualitative study of patients' and their partners' experiences of rehabilitation at home. Scandinavian Journal of Caring Sciences 31(2): 302-311, 2017