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Utilization of health care resources after stroke. A population‐based study of 258 hospitalized cases followed during the first year
Author(s) -
Thorngren M.,
Westling B.
Publication year - 1991
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1991.tb04959.x
Subject(s) - medicine , stroke (engine) , emergency medicine , health care , population , rehabilitation , hospital care , acute care , hospital bed , physical therapy , environmental health , nursing , mechanical engineering , engineering , economics , economic growth
In a prospective population‐based study the cumulative utilization of health care resources (and the rehabilitation outcome) was followed in consecutive stroke patients 3, 6 and 12 months after the onset of the disease. The study group comprised 258 patients diseased during the period February 1st 1986‐January 31th 1987. The pattern of various forms of hospital beds and non‐hospital facilities in open care utilized during the first post‐stroke year was analysed at 1986 year's cost level. The mean utilization of acute hospital beds during the initial phase was 15 days; at an expenditure cost of 26,670 SEK (3,683). The mean utilization of acute hospital and of geriatric beds during the first year was 19 and 59 days respectively. Thus the total hospital bed days amounted to a mean of 78 days; at a mean expenditure of 87,000 SEK (12,000); 70% of the patients were discharged from hospital care to independent living after 36 days. The acute care hospital provided 36% and geriatric care 64% of the beds needed before discharge. The expenditure of non‐hospital facilities was mean 19,000 SEK (2600); thus total expenditure for health care amounted to 106,000 SEK (14,600). The relation between non‐hospital and hospital care was approximately 1 to 5. Severity of the stroke influenced markedly the pattern and the total utilization of both hospital and non‐hospital care. Patients with major stroke utilized health care resources at an expenditure 3.5 times that used by patients with minor stroke. Age of the patient also influenced health care utilization. However, age had no influence on mean utilization of acute hospital beds but influenced the utilization of geriatric beds and non‐hospital facilities. The large amount of acute hospital bed days used by the older patients depended entirely on their increased number. When only patients with major stroke were analysed, the impact of age on health care utilization became less prominent. The effort to prevent and/or minimize the disability following stroke stands out as the dominant and most desirable approach to save resources and human suffering.