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The effectiveness of systematic stroke care.

A coordinated, multidisciplinary approach had been applied to enhance the effectiveness of stroke care with varying enthusiasm; however, the effectiveness of this kind of stroke treatment model was noted in many studies. This study was designed to measure the effectiveness of systematic stroke management on the physical-functional outcome in terms of Activities of Daily Living (ADLs) scores. The higher the ADLs score, the higher the degree of physical disability, i.e., the higher the degree of dependence. Eighty-six stroke patients from the Department of Neurology in a medical center, and 88 stroke patients from the Department of Medicine in a local hospital were followed from the admission day to the discharged date. The effectiveness of stroke care in each hospital was measured by the comparisons between ADLs scores at discharge and ADLs scores at admission. Two-sample tests show that demographic characteristics, length of stay, average time elapsed since the occurrent stroke, number of families in caregiving, and ADLs scores at admission and at discharge did not differ much between these two groups. The improved ADLs scores for stroke patients treated in the Department of Neurology of the medical center were changed from the 14.1 +/- 4.9 at admission to 12.1 +/- 5.2 at discharge, and the changes of ADLs scores for patients treated in the Department of Medicine of the regional hospital was from 12.8 +/- 5.1 to 12.3 +/- 5.5 according to the degree of improvement. The significant finding was that the degree of improvement of ADLs scores for CVA patients from the medical center was significant (Wilcoxon Matched-Pairs Signed-Ranks Test, Z = -2.8, p < 0.01). Moreover, the degree of improvement of ADLs scores strongly differed between these two groups (Repeated measures of two-way ANOVA, F = 6.0, p < 0.05). The information presented here informs us that degree of physical-functional status of stroke patients should be improved because of the systematic stroke management.