Abstract
Background and Purpose: The Japanese government emphasizes the importance of long-term community care for stroke patients by acute hospitals (AH), convalescent rehabilitation units (CRU), general practices (GP), sanatorium type wards (STW), long-term care facilities (LTCF) and in-home and commuting care services (IHCCS). We conducted a nationwide questionnaire survey to assess the current role of IHCCS in stroke care. Subjects and Methods: Twelve representative prefectures were selected. Questionnaires concerning the facility status, community-based referral system, long-term care insurance system and their appropriate indicators were sent to 10% of the IHCCS. Results: 22% these of IHCCS answered. 80% offered post-stroke care services, and half of these did so regardless of the condition of the post-stroke person. Each IHCCS looked after 112±210 (mean±SD) persons including 26±41 post-stroke cases. Although 81% engaged in some form of post-stroke rehabilitation, only 10% answered that their post-stroke rehabilitation was adequate. CRU (38%) were expected to play a central role in the community-based referral system. Good or fair relationships with AH, CRU, GP, STW/LTCF, other IHCCS, the general community and the local authority were found in 37%, 37%, 51%, 48%, 58%, 38% and 20%, respectively. Medical/care information sharing was achieved in 9%/10% and not scheduled in 62%/59%. The proper assessment indicator for IHCCSS by a third party was the communication with care managers for long-term care services (44%). Conclusions: The cooperation between IHCCS and AH, CRU and the local authority was insufficient. At present, the information sharing for stroke patients in IHCCS remains unsatisfactory.
