Rehabilitating stroke survivors in the community could save the health service between €2 million and €7 million a year and free up more than 24,000 hospital bed days, while improving outcomes for patients, according to a report.
Almost half of all stroke survivors – almost 3,000 people a year – could benefit from early supported discharge programmes, the report by the Economic and Social Research Institute (ESRI) and the Irish Heart Foundation says.
Early supported discharge is an intensive approach to rehabilitation in the community, used internationally for stroke survivors with mild to moderate disability, but not generally available in Ireland. It requires greater numbers of physiotherapists, occupational therapists and speech and language therapists.
The report says the cost of providing these extra resources could be more than met through the saving in bed days. It says community and inpatient rehabilitation for stroke survivors is poorly resourced and there are wide regional variations in services.
“The analysis in this report supports a move to international best practice in stroke rehabilitation in Ireland, with the potential for better outcomes for patients from better care in the community,” said lead author Dr Maev-Ann Wren of the ESRI.
Strokes services have been improved in recent years, with a 13 per cent reduction in the death rate and a 28 per cent fall in the numbers being discharged to nursing homes. There are an estimated 50,000 people living after a stroke.
"That means more people than ever are returning home after stroke, but community services to maximise their recovery have remained as bad as ever, with appalling quality of life consequences for discharged stroke patients," said Barry Dempsey, chief executive of the Irish Heart Foundation.
One in three survivors has no access to physiotherapy and half cannot get speech and language therapy or occupational therapy. More than one-third pay privately for rehabilitation.
The report also recommends the establishment of a national stroke register to record treatments, outcomes and care in hospitals, the community and long-term care settings.
