Post-stroke rehabilitation: an economic or medical priority? Current issues and prospects in light of new legislative regulations

Ital J Neurol Sci. 1998 Feb;19(1):25-31. doi: 10.1007/BF03028808.

Abstract

The aim of this study was to evaluate: 1) whether the reduction in duration of in-patient rehabilitation imposed by the Italian Ministry of Health's circular of 29/6/95 has been accompanied by a decline in the results achieved; and 2) whether the system of basing payments on diagnosis related group (DRG) criteria is capable of correctly evaluating differences in post-stroke clinical pictures. The study involved 461 of 497 patients consecutively admitted between 1991 and 1996 for rehabilitation after a first stroke. The average duration of hospitalisation for the period 1995-1996 was significantly shorter (p<0.001) than that of the previous years; at the same time, there was a significant increase (p<0.05) in the number of poor responders in both neurological and functional (mobility) terms. Furthermore, the early discharge after 60 days of the 1995-1996 patients compromised the stabilisation of recovery and led to a subsequent functional decline. It is therefore hoped that the current regulations will be revised and that payments based on a functional related group (FRG) criterion will be introduced.

MeSH terms

  • Aged
  • Diagnosis-Related Groups / economics
  • Diagnosis-Related Groups / legislation & jurisprudence
  • Female
  • Health Priorities
  • Hospitalization / economics
  • Hospitalization / legislation & jurisprudence
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care*
  • Recovery of Function
  • Rehabilitation / economics*
  • Rehabilitation / legislation & jurisprudence*
  • Stroke / economics*
  • Stroke / therapy
  • Stroke Rehabilitation*
  • Treatment Outcome