Costs and length of stay associated with early supported discharge for moderate and severe stroke survivors.

This study aimed to compare the length of stay, saved days and service costs associated with an early supported discharge model of care for mild, moderate and severe stroke survivors, to standard treatment. A two centre cohort study, employing a quasi-experimental design with a control group of convenience. Forty-four participants were recruited when they were deemed suitable for discharge home with intensive rehabilitation and services, with three dropouts from the treatment group (treatment n = 28, control n = 13). There were no significant differences between the groups for gender, age, Functional Independence Measure, Berg Balance Test and Modified Ranking Scale total scores at baseline. There were also no significant differences between the groups for subsequent readmissions or complications. Length of stay was measured by the days between admission and discharge from both inpatient and community services. Costs were measured by daily amounts calculated for this service. The treatment group spent significantly fewer days on the acute and inpatient rehabilitation wards, with over half avoiding subacute admission altogether. However, the control group spent significantly fewer days receiving intensive rehabilitation. The treatment group cost less on average per patient, but was not significantly different in terms of overall costs per admission. Stroke survivors receiving an early supported discharge model of care spent fewer days in hospital, frequently avoided subacute admission and incurred less cost per patient than those receiving standard treatment. These findings indicate that early supported discharge reduces length of inpatient stay, for a similar cost to standard treatment.

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