HOME CARE VS. HOSPITAL DAY CARE AFTER STROKE.

Given the prolonged nature of stroke recovery, a number of post-discharge approaches to care have been developed. This British group compared home physiotherapy with hospital day care in 108 patients over age 60 who were suffering residual disability from a new stroke. Patients were randomized to receive either home care or day care and were followed for six months. Each group underwent four standardized assessments of physical, psychological, social, and overall health status.

Although both groups had significant improvements in physical function during the six months, the home-care group did slightly better. For instance, 45 percent of home-care patients were able to walk outdoors independently, compared with only 23 percent of the hospital day-care group, despite the fact that the home-care group received less care (a median of 15 visits from a therapist, versus 31 visits made by the day-care group to the hospital). There were no significant differences between groups in any of the other measures of health status.

The authors conclude that home care seems slightly more effective and more resource-efficient than day care. Neither approach was particularly effective at enhancing other outcomes, such as psychosocial functioning.

— KIM

Published in Journal Watch General Medicine June 2, 1992

Citation(s):

Young JB; Forster A. The Bradford community stroke trial: results at six months. BMJ 1992 Apr 25 304 1085-1089.

Source : http://general-medicine.jwatch.org/cgi/content/full/1992/602/2