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Background In May 2012, the Central Denmark Region implemented a reform in stroke care, which included concentration of acute stroke treatment from 5 to 2 specialized hospitals, short stay, and a shift from inpatient rehabilitation to community-based rehabilitation, and establishment of 5 stroke teams. The plan was announced three months before implementation. Patients were promised a more integrated care pathway with newly established stroke teams supporting the discharge and rehabilitation in the home municipality. In this reform, only hospital care is within the Region’s area of control, as rehabilitation at home is the responsibility of municipalities in this decentralized health care system. The top-down implementation of this reform poses therefore some challenges.

Implementation of a regional stroke reform in Denmark: a tale of cost reduction and quality improvement