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(Stroke. 2003;34:2691.)
© 2003 American Heart Association, Inc.

Original Contributions

Editorial Comment—Early Supported Discharge: An Idea Whose Time Has Come?

Academic Section of Geriatric Medicine, Royal Infirmary, Glasgow, UK

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In most developed countries, stroke patients follow a broadly predictable pathway of care beginning with hospital admission. In hospital they receive acute care and a variable period of rehabilitation, but rehabilitation services frequently stop or are significantly reduced after discharge home from hospital. Early supported discharge (ESD) services aim to alter this conventional pathway of care in 2 ways; first, by moving forward the time of discharge from hospital, and second, by providing a more continuous process of rehabilitation spanning both the period in hospital and the first few weeks at home.¹

There have been several arguments made in favor of the ESD concept. First, in countries like the United Kingdom it has been argued² that more stroke patient care should be provided in a community setting. Second, it has been claimed that ESD services can be less costly than conventional services and allow a freeing up of hospital beds.³ Finally, it has been suggested that ESD services can improve patient care by providing a seamless service that spans the period of discharge home, a time that patients and carers frequently find difficult. In contrast, critics have argued that most stroke patients are discharged as early as is reasonably possible. They also point out the potential hazard of trying to manage dependent patients at home with the risk of increasing stress on carers and causing poorer patient outcomes.⁴

Until recently, none of these assertions had been adequately tested in clinical trials. However, since 1997 several single-blind randomized controlled trials have reported, initially . . . [Full Text of this Article]

This article has been cited by other articles:

				A.-M. Thorsen, L. Wides Holmqvist, J. de Pedro-Cuesta, and L. von Koch A Randomized Controlled Trial of Early Supported Discharge and Continued Rehabilitation at Home After Stroke: Five-Year Follow-Up of Patient Outcome Stroke, February 1, 2005; 36(2): 297 - 303. [Abstract] [Full Text] [PDF]