STROKE REHABILITATION IN SOUTH AUCKLAND - THE VALUE OF AN EFFECTIVE REHABILITATION UNIT

Aim. To assess the validity of Barthel based poststroke triage, the effectiveness of a rehabilitation unit in minimising poststroke institutionalisation, and medical resource utilisation for stroke management. Methods, A prospective study of stroke outcome for 115 consecutive patients admitted to Middlemore Hospital, Auckland, between March and September 1993, based on Barthel functional assessments at 1 week and 3 months poststroke, postdischarge domicile and duration of inpatient stay in both acute medical and rehabilitation units. Results. For the 73 patients offered rehabilitation, 48 (76%) of the survivors were able to return home after a mean period of 6 weeks. Of 24 subjects with 1 week Barthel scores of five or less, 15 of 19 (84%) survivors returned to their original domicile. Of eight patients with 1 week Barthel scores of two or less, all survived and five returned home. The median delay between admission by the acute medical service and transfer to the rehabilitation unit was only four days for the 70 patients involved. Conclusion. Our data provides local confirmation of internationally increasing acceptance of the effectiveness of rehabilitation units in reducing expensive long term institutionalisation and freeing up stressed acute medical resources.