Influence of a Liaison-clinical Pathway on the Length of Stay and the Functional Independence Measure Gain of Stroke Patients in the Nakaharima and Nishiharima District Medical Facilities Network in Hyogo Prefecture / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

Objective: The aim of this study was to examine the influence of a liaison-clinical pathway for stroke rehabilitation. Methods: We initiated the pathway in January 2008. The patients enrolled in this study included 82 patients with acute stroke sustained during the 4 months after the initiation of the pathway and 151 patients with acute stroke sustained during the same period in the following year. Results: The mean length of stay in acute stroke centers was significantly reduced in the second year of employing the pathway. However, an evident reduction of the functional independence measure gain was observed in the convalescent rehabilitation wards, especially in severely physically handicapped patients. Conclusion: The liaison-clinical pathway is an effective approach for advancing a regional cooperation network among hospitals and for shortening the stay in acute stroke centers. On the other hand, the clinical outcome of stroke patients can deteriorate if enough efforts are not made to improve the medical management of severely physically handicapped patients in convalescent rehabilitation wards.