Kontakt 2021, 23(3):187-192 | DOI: 10.32725/kont.2021.013

Early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic: a comparison of three stroke unitsSocial Sciences in Health - Original article

Anna Kratochvílová¹, Vladimír Rogalewicz², Yvona Angerová², Tereza Gueye^{2, 3}, Pavel Maršálek⁴, Irina Chmelová^{5, 6}, Miroslav Barták^{7, *}

¹ Czech Technical University in Prague, CzechHTA, Faculty of Biomedical Engineering, Department of Biomedical Technology, Kladno, Czech Republic

² Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Rehabilitation Medicine, Prague, Czech Republic

³ University Hospital Královské Vinohrady, Department of Rehabilitation Medicine, Prague, Czech Republic

⁴ Krajská zdravotní, a. s., Masaryk Hospital in Ústí nad Labem, Rehabilitation Department, Ústí nad Labem, Czech Republic

⁵ University Hospital Ostrava, Clinic of Rehabilitation and Physical Medicine, Ostrava, Czech Republic

⁶ University of Ostrava, Faculty of Medicine, Department of Rehabilitation, Ostrava, Czech Republic

⁷ University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, Institute of Social and Special-paedagogical Sciences, České Budějovice, Czech Republic

Quality of life and costs related to stroke survivors are important issues for the Czech healthcare system. Early rehabilitation after stroke has a great potential to improve patients' quality of life as well as to contribute to saving long-term societal costs. A tri-centre pragmatic longitudinal study was focused on the economic analysis of early rehabilitation after stroke in hospitals in the Czech Republic. The research also revealed dissimilarities in procedures between the involved hospitals. The number of patients included in the study was 87 (Prague - 29, Ústí nad Labem - 31, Ostrava - 27). All of them were admitted to the early rehabilitation unit less than 70 days after stroke. Data were collected using the bottom-up method alongside the standard patient care. The inter-hospital differences manifested themselves mainly in the severity of the patients transferred from neurology to early rehabilitation wards, length of the hospitalization, average cost of the hospital stay, and to some degree also in the clinical outcomes (represented by the FIM scores). The analysis showed improvements in clinical outcomes in all groups and all hospitals. The differences in the costs of the hospitalization were caused predominantly by hospitalization length. The differences in the average one-day costs were caused only by particular hospitals' treatment procedures and operational processes.

Keywords: Czech Republic; Early rehabilitation; Inter-hospital differences; Stroke

Grants and funding:

The research leading to this paper was supported by the grant No. 410004194 provided by the General Health Insurance Company of the Czech Republic from their Secondary Prevention Fund.

Conflicts of interest:

The authors have no conflict of interests to declare.

Received: December 13, 2020; Revised: February 11, 2021; Accepted: April 8, 2021; Prepublished online: April 9, 2021; Published: September 3, 2021  Show citation