Bae Suk Won, Kwon Junhyun, Shin Hyung-Ik
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Front Neurol. 2023 Jun 16;14:1135568. doi: 10.3389/fneur.2023.1135568. eCollection 2023.
This study aimed to investigate the utilization of post-ischemic stroke rehabilitation prior to the introduction of the post-acute rehabilitation system in South Korea in 2017.
Medical resources utilized for patients with cerebral infarction hospitalized at Regional Cardio-Cerebrovascular Centers (RCCVCs) of 11 tertiary hospitals were tracked until 2019. Stroke severity was classified according to the National Institutes of Health Stroke Scale (NIHSS), and multivariate regression analysis was performed to analyze factors influencing the length of hospital stay (LOS).
This study included 3,520 patients. Among 939 patients with stroke with moderate or greater severity, 209 (22.3%) returned home after RCCVC discharge without inpatient rehabilitation. Furthermore, 1,455 (56.4%) out of 2,581 patients with minor strokes with NIHSS scores ≤4 were readmitted to another hospital for rehabilitation. The median LOS of patients who received inpatient rehabilitation after RCCVC discharge was 47 days. During the inpatient rehabilitation period, the patients were admitted to 2.7 hospitals on average. The LOS was longer in the lowest-income group, high-severity group, and women.
Before the introduction of the post-acute rehabilitation system, treatment after stroke was both over- and under-supplied, thus delaying home discharge. These results support the development of a post-acute rehabilitation system that defines the patients, duration, and intensity of rehabilitation.
本研究旨在调查2017年韩国引入急性后期康复系统之前缺血性中风康复的利用情况。
追踪了11家三级医院的地区心脑血管中心（RCCVCs）收治的脑梗死患者所使用的医疗资源，直至2019年。根据美国国立卫生研究院卒中量表（NIHSS）对中风严重程度进行分类，并进行多因素回归分析以分析影响住院时间（LOS）的因素。
本研究纳入了3520例患者。在939例中度或更严重中风患者中，209例（22.3%）在RCCVC出院后未接受住院康复治疗就回家了。此外，在2581例NIHSS评分≤4的轻度中风患者中，有1455例（56.4%）再次入院接受康复治疗。RCCVC出院后接受住院康复治疗的患者的中位住院时间为47天。在住院康复期间，患者平均入住2.7家医院。最低收入组、高严重程度组和女性的住院时间更长。
在引入急性后期康复系统之前，中风后的治疗供应过度和不足并存，从而延迟了出院回家。这些结果支持开发一种急性后期康复系统，该系统可以确定康复的患者、持续时间和强度。
