Stroke service in the Netherlands: an exploratory study on effectiveness, patient satisfaction and utilisation of healthcare

Abstract

Objective: To assess whether shared care for stroke patients results in better patient outcome, higher patient satisfaction and different use of healthcare services. Design: Prospective, comparative cohort study. Setting: Two regions in the Netherlands with different healthcare models for stroke patients: a shared care model (stroke service) and a usual care setting. Patients: Stroke patients with a survival rate of more than six months, who initially were admitted to the Stroke Service of the University Hospital Maastricht (experimental group) in the second half of 1997 and to a middle sized hospital in the western part of the Netherlands between March 1997 and March 1999 (control group). Main outcome measures: Functional health status according to the SIP-68, EuroQol, Barthel Index and Rankin Scale, patient satisfaction and use of healthcare services. Results: In total 103 patients were included in this study: 58 in the experimental group and 45 in the control group. Six months after stroke, 64% of the surviving patients in the experimental group had returned home, compared to 42% in the control group (p Conclusions: The Stroke Service Maastricht resulted in a higher number of patients who returned home after stroke, but not in a better health status. Since patients in the usual care group received a higher volume of healthcare in the period of rehabilitation, the Stroke Service Maastricht might be more efficient.

Keywords

• transmural care
• shared care
• stroke service
• effectiveness