Stroke rehab can lower readmissions

Stroke care has become an immediate healthcare priority of India. Aligned with global trend, India too is a victim of stroke — a long-term disability. The country also ranks high in the number of early stroke victims compared to developed economies. This means active and earning member suffering from stroke will impact not just the person, but the complete family and work place too.

Efforts are underway to improve stroke care in India through a range of methodological approaches and multidisciplinary researches. Yet the alarming number of hospital readmissions within the first 30 days of discharge is negatively affecting the critical work done at hospitals. This not only escalates the overall healthcare expenditure, but also pushes the recovering person and family back to where they began.

Readmission is commonplace among disabled stroke survivors. Even with the best treatments and healthcare practice in place, the chances of developing complications and a second stroke are high during the recuperation period.

However, researches reveal a majority of those who underwent a structured multidisciplinary transitional care rehabilitation programme in an inpatient rehabilitation centre soon after their discharge from hospital, reported reduced readmissions and mortality rates. This is in addition to having the benefit of effective recovery in terms of functional independence and quality of life.

The complexities of managing a stroke and the co-morbidities associated with it are so high that hospitals struggle to provide extended care for patients. This is where Inpatient Rehabilitation Centres specialised in stroke rehabilitation come to play. Bridging the acute care gap between critical care hospitals and home care setting, these centres provide multidisciplinary care for stroke survivors.

Overseen by a team of doctors comprising rehabilitation therapists, occupational therapists, speech therapists, respiratory therapists, nutritionists and counsellors; skilled nurses and physiotherapists provide the required care. Together, they work towards a common goal to improve the overall quality of a patient’s life and provide a quicker and empowered recovery.

Stroke rehabilitation is a clinical intervention designed to reduce the long-term impact caused by stroke. The physical, emotional and social aspects of the patient’s life are modified so that he gains independence and confidence to get back to his active life. Ideally, rehabilitation should be initiated in a patient right from the hospital bed, after the stroke attack has occurred.

Depending on the severity of the stroke, the next level of rehabilitation is determined. The rehabilitation options range from inpatient rehabilitation centres to home therapy. Inpatient rehabilitation in an organised setting can prevent post stroke complications. Deep vein thrombosis, pneumonia, seizures, depression, spasticity and infections are some of the common and importantly preventable.

Continued medical monitoring is vital in the recovery of a stroke survivor. Involving family and primary treating doctor, it is advisable for the patient to be under the constant care of a multidisciplinary rehab care team during the first 90 days of recovery. This phase is commonly referred to as the “Golden period”, since most of the neurological recovery happens during this time.

Hospital beds can’t be blocked for a single patient for a prolonged period for multiple of reasons. Moreover, the function of hospitals is to provide critical medical care to a patient until he is stable. Beyond providing life-supporting care, no hospital can afford to offer continued care especially for stroke patients who will need longer time to recover completely.

At the same time, every doctor’s aim is to help his patient get back home sooner and safer. This is precisely the reason why developed healthcare systems of the world maintain the care continuum though transition care hospitals. Soon after a patient recovering from an unanticipated critical illness like stroke is declared stable, he is referred to an inpatient rehabilitation centre. This ensures the patient receives proper medical care until complete recovery.

The number of stroke cases reported every year in India is growing at an exponential pace. While prevention is always better than cure, we can also bring down this enormous burden on our healthcare system by reducing the equally rising number of stroke-associated readmission cases. An efficient care system built on a thriving partnership between hospitals and stroke rehabilitation centres can yield positive medical, economic and social outcomes.

(The writer is Director, New Initiatives, SuVitas Holistic Healthcare)