Reevaluating post-stroke care

With healthcare costs soaring, hospitals and insurers are searching for ways to reduce expenses while maintaining quality. It’s a tricky, difficult proposition.

Popular areas to pare down are postacute care and rehabilitation. However, members of an American Heart Association/American Stroke Association guidelines committee argue that treating patients who suffer strokes at rehabilitation facilities is imperative to keeping them healthy in the long-term. The authors released their guidelines in Stroke on May 4.

“The provision of comprehensive rehabilitation programs with adequate resources, dose, and duration is an essential aspect of stroke care and should be a priority in these redesign efforts,” they wrote.

Carolee J. Winstein, PhD, the chair of the guidelines committee, and colleagues argue that patients who survive strokes should be sent to in-patient rehabilitation facilities rather than skilled nursing facilities.

“There is considerable evidence that patients benefit from the team approach in a facility that understands the importance of rehabilitation during the early period after a stroke,” Winstein said in a news release.

Sending patients to rehabilitation facilities following strokes could also help decrease costs because patients would not suffer as many future health issues. Still, the authors said more research is needed to determine how to best take care of such patients.

They suggested evaluating multimodal interventions such as drugs, therapy and brain stimulation; considering computer-adapted assessments for personalized and tailored interventions; using new technologies such as virtual reality, body-worn sensors and social media; and considering stroke as a chronic condition rather than just an acute event.

For now, the authors said that stroke survivors should receive support from family members, caregivers, physicians, nurses, therapists and anyone else who can help them. 

“Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation and underlie this entire guideline,” they wrote. “Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.”

-Tim Casey
Executive Editor