A comparison of ‘combined stroke units’ and their benefits within Europe and the United Kingdom

摘要

The burden from stroke is sizable in terms of disease and healthcare costs, with expenditure growing. Outcomes in the United Kingdom continue to compare poorly internationally, with long lengths of inpatient stay and high levels of disability/mortality. Research shows that meeting the needs of stroke patients is easier in combined acute and rehabilitation settings, such as combined stroke units. This qualitative study aims to provide organisations, commissioners, stroke teams/ services and individual practitioners with insight into examples of best practice.Data was collected from combined stroke units excelling in meeting patient needs in the UK, Germany, Sweden and Norway during visits lasting one to two days. Analysis of this data highlights that a combined stroke unit label is not important, with early intervention and rehabilitation key to recovery. Additionally, nursing to patient ratio within the UK stroke units is far lower than in Europe. In order to facilitate best practice, this needs reviewing, as reduced staffing levels hinder patient rehabilitation. This study also found that stroke professionals need to share responsibilities between professional groups, as the priority should always be the patient’s needs, aspirations and goals.Future research should focus on comparing stroke unit structures and whether benefits in stroke care are dependent on having dedicated stroke wards and effective models of care.