Outcomes of Short-Course Inpatient Stroke Rehabilitation Program in Tertiary Hospital: A Pilot Study
Rachawan Suksathien MD*, Yaowaluk Chaiyaphan RN**, Chantana Roongyoosiri BSc*, Phuwadol Muangkham BSc*
Affiliation : * Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand ** Department of Nursing, Rehabilitation Ward, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
Background : Stroke is one of the most common cause of disabilities in Thailand. Full-course comprehensive rehabilitation
to achieve maximum goal for each patient was uncommon in secondary and tertiary hospitals because of limited resources
and budget, so short-course inpatient stroke rehabilitation program was developed for service in these circumstances.
Objective : To evaluate the efficiency and cost of the short-course inpatient stroke rehabilitation in Maharat Nakhon
Ratchasima Hospital.
Material and Method: This prospective study included stroke patients with aged over 18 years old, able to follow one-step
command and admitted in rehabilitation ward for short-course rehabilitation program between January 1 and December
31, 2014. Patient’s characteristic data, Barthel Index (BI) scores, BI effectiveness, BI efficiency, length of stay (LOS), Thai
Hospital Anxiety and Depression Scale (THAI HADS), WHOQOL-BREF-THAI, cost, and details of training were recorded.
Results : Fifty stroke patients were included in the present study. The mean interval from onset of stroke to admission for
this program was 29.9 days (1-143, SD 31.18). The mean age was 57 years (19-86, SD 12.7). Seventy-two percent of cases
were ischemic stroke. The impairments of the patients were hemiparesis (100%), aphasia (36%), dysarthria (32%),
incontinence (14%), cognitive problem or neglect (12%), and dysphagia (10%). The mean LOS was 9.38 days (3-27, SD
5.31). Mean BI score on admission and at discharge were 8.12 (0-18, SD 4.52) and 13.12 (2-20, SD 4.28). The mean of BI
score change was 5 (2-10, SD 2.25). The BI efficiency was 0.56 points/day. Eight cases (22%) had anxiety and 10 cases
(28%) had depression. The mean total cost was 7,729 baht (1,828-22,450, SD 4,330) or about 240 US dollar.
Conclusion : The short-course inpatient rehabilitation program could improve functional ability in stroke patients with low
cost but high efficiency. This program is suitable for subacute stroke patients in hospitals with limited resources and budget.
Keywords : Stroke, Rehabilitation, Treatment outcome
