Outcome and Use of Health Care in Patients with Moderate Impairment and Stroke in South Madrid and Southwest Stockholm

Background: A comparison was performed on two groups of patients with acute stroke and moderate impairment recruited in south Madrid and southwest Stockholm, with particular focus on function, activity, health-related quality of life, and use of health care resources. Methods: In all, 27 Spanish and 38 Swedish patients were included; 5 to 10 days after stroke all patients were continent and independent in feeding, had a normal cognitive status, and impaired motor capacity or aphasia. Patients were evaluated at baseline and at 3 and 6 months after stroke using a standardized protocol; information on use of health care resources was also collected. Results: Stroke severity at baseline, function and activity at 6 months, and total use of rehabilitation were similar in both groups. The Madrid group showed: (1) lower levels of function and activity at baseline and health-related quality of life at 3 months; (2) shorter length of hospital stay and lower use of hospital-based rehabilitation; and (3) several-fold higher use of outpatient rehabilitation. Conclusions: Differences of the organization of acute stroke care for patients with moderate impairment in south Madrid and southwest Stockholm, including the timing and distribution of rehabilitation services, were remarkable and plausible explanation for temporal differences in patient outcome.