A multicenter study to compare the effectiveness of the inpatient post acute care program versus traditional rehabilitation for stroke survivors

Ke Vin Chang, Kai Hua Chen, Ying Hsun Chen, Wei Chih Lien, Wei Han Chang, Chung Liang Lai, Cheng Che Wu, Chia Hsin Chen, Yu Hsin Chen, Wei Ting Wu, Tyng Guey Wang, Der Sheng Han

Research output: Contribution to journalArticlepeer-review

Abstract

There is insufficient evidence to prove the effect of the Post-acute Care (PAC) program on post-stroke recovery. This study aimed to determine the effectiveness of the PAC versus traditional inpatient rehabilitation (non-PAC) for middle- and old-aged stroke survivors. This multicenter cohort study enrolled 334 stroke patients admitted for post-stroke rehabilitation. The outcome variables included the Barthel Index (BI), Functional Oral Intake Scale (FOIS), Mini Nutritional Assessment-Short Form (MNA-SF), EuroQoL-5D (EQ-5D), Lawton–Brody Instrumental Activities of Daily Living (ADL) Scale, and Mini-Mental State Examination (MMSE). The inverse-probability-of-treatment-weighting method was used to analyze the differences in outcomes between the PAC and non-PAC groups. The PAC group showed better improvements in BI, MNA-SF, EQ-5D, Instrumental ADL, and MMSE compared to the non-PAC group, with differences in effect sizes of 0.54 (95% confidence interval [CI] 0.38–0.71), 0.26 (95% CI 0.10–0.42), 0.50 (95% CI 0.33–0.66), 0.44 (95% CI 0.28–0.60) and 0.34 (95% CI 0.17–0.50), respectively. The PAC project showed more improvement in basic and instrumental ADL and status of swallowing, nutrition, and cognition than those of non-PAC, which had less length of stay restricted by the National Health Insurance. More studies are warranted to investigate the influence of hospital stay and duration from stroke onset on the PAC’s effectiveness.

Original languageEnglish
Article number12811
JournalScientific reports
Volume12
Issue number1
DOIs
Publication statusPublished - 2022 Dec

All Science Journal Classification (ASJC) codes

  • General

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