{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T11:38:57Z","timestamp":1775561937832,"version":"3.50.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,4]]},"abstract":"<jats:p><jats:italic>Background and Purpose<\/jats:italic>\u2014In an inner-London teaching hospital, a randomized trial of \u201cconventional\u201d care versus early discharge to community-based therapy found no significant differences in clinical outcomes between patient groups. This report examines the economic consequences of the alternative strategies.<\/jats:p><jats:p><jats:italic>Methods<\/jats:italic>\u2014One hundred sixty-seven patients received the early discharge package, and 164 received conventional care. Patient utilization of health and social services was recorded over a 12-month period, and cost was determined using data from provider departments and other published sources.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>\u2014Inpatient stay after randomization was 12 days (intervention group) versus 18 days (controls) (<jats:italic>P<\/jats:italic>=0.0001). Average units of therapy per patient were as follows: physiotherapy, 22.4 (early discharge) versus 15.0 (conventional) (<jats:italic>P<\/jats:italic>=0.0006); occupational therapy, 29.0 versus 23.8 (<jats:italic>P<\/jats:italic>=0.002); speech therapy, 13.7 versus 5.8 (<jats:italic>P<\/jats:italic>=0.0001). The early discharge group had more annual hospital physician contacts (<jats:italic>P<\/jats:italic>=0.015) and general practitioner clinic visits (<jats:italic>P<\/jats:italic>=0.019) but fewer incidences of day hospital attendance (<jats:italic>P<\/jats:italic>=0.04). Other differences in utilization were nonsignificant. Average annual costs per patient were \u00a36800 (early discharge) and \u00a37432 (conventional). The early discharge group had lower inpatient costs per patient (\u00a34862 [71% of total cost] versus \u00a36343 [85%] for controls) but higher non-inpatient costs (\u00a31938 [29%] versus \u00a31089 [15%]). Further analysis demonstrated that early discharge is unlikely to lead to financial savings; its main benefit is to release capacity for an expansion in stroke caseload.<\/jats:p><jats:p><jats:italic>Conclusions<\/jats:italic>\u2014Overall results of this trial indicate that early discharge to community rehabilitation for stroke is cost-effective. It may provide a means of addressing the predicted increase in need for stroke care within existing hospital capacity.<\/jats:p>","DOI":"10.1161\/01.str.30.4.729","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:10:52Z","timestamp":1308341452000},"page":"729-735","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Economic Consequences of Early Inpatient Discharge to Community-Based Rehabilitation for Stroke in an Inner-London Teaching Hospital"],"prefix":"10.1161","volume":"30","author":[{"given":"Roger","family":"Beech","sequence":"first","affiliation":[{"name":"From the Centre for Health Planning and Management, Keele University, Staffs (R.B.); Elderly Care Unit, St Thomas\u2019s Hospital, London (A.G.R.); and Department of Public Health Medicine, United Medical and Dental School, London (K.T., C.D.A.W.), England."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony G.","family":"Rudd","sequence":"additional","affiliation":[{"name":"From the Centre for Health Planning and Management, Keele University, Staffs (R.B.); Elderly Care Unit, St Thomas\u2019s Hospital, London (A.G.R.); and Department of Public Health Medicine, United Medical and Dental School, London (K.T., C.D.A.W.), England."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Tilling","sequence":"additional","affiliation":[{"name":"From the Centre for Health Planning and Management, Keele University, Staffs (R.B.); Elderly Care Unit, St Thomas\u2019s Hospital, London (A.G.R.); and Department of Public Health Medicine, United Medical and Dental School, London (K.T., C.D.A.W.), England."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles D. A.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"From the Centre for Health Planning and Management, Keele University, Staffs (R.B.); Elderly Care Unit, St Thomas\u2019s Hospital, London (A.G.R.); and Department of Public Health Medicine, United Medical and Dental School, London (K.T., C.D.A.W.), England."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Annual World Health Statistics. Geneva Switzerland: World Health Organization; 1990 1991 1992."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)90348-7"},{"key":"e_1_3_2_3_2","unstructured":"Office of Health Economics. Stroke. 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