The effectiveness and costs of intensive stroke rehabilitation and improvements in patient pathway in Finland: a retrospective benchmarking controlled trial.

Publisher: MJS Publishing Country of Publication: Sweden NLM ID: 101088169 Publication Model: Electronic Cited Medium: Internet ISSN: 1651-2081 (Electronic) Linking ISSN: 16501977 NLM ISO Abbreviation: J Rehabil Med Subsets: MEDLINE

Publication: 2024- : Uppsala, Sweden : MJS Publishing
Original Publication: Stockholm, Sweden : Taylor & Francis, c2001-

Stroke Rehabilitation*/economics ; Benchmarking*; Humans ; Finland ; Retrospective Studies ; Male ; Female ; Aged ; Middle Aged ; Critical Pathways/economics ; Patient Discharge ; Stroke/economics ; Treatment Outcome

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 region compared with other parts in Finland.
Design: Retrospective benchmarking controlled trial.
Patients: Three cohorts of Finnish community-dwelling patients (n = 94,749, n = 4,184, and n = 105,458) 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 stroke rehabilitation in Lahti increased the share of patients discharged home (p = 0.005) and decreased the length of first institutional episode (-4 days, p = 0.006), the share of patients institutionalized (-5.1%, p = 0.001), and the costs of first institutional 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 for patients and reduced costs for the healthcare system.

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Date Created: 20241114 Date Completed: 20241114 Latest Revision: 20241122

20241122

PMC11577621

10.2340/jrm.v56.34944

39539068