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 STW/LTCF in stroke care. Subjects and Methods: Twelve representative prefectures were selected. Questionnaires concerning the facility status, community-based referral system and their appropriate indicators were sent to 771 STW/LTCF. Results: 24% of these STW/LTCF answered. 82% were engaged in stroke long-term care. There were 106 (mean) beds (37 for stroke patients). The waiting period to enter was over 6 months in 22%. The main reasons for the observed difficulty in returning home were living alone (73%), only elderly people's households (76%) and other reasons for lack of care (77%); and only 10% of stroke patients returned home. Only 15% could maintain adequate function for rehabilitation. AH (42%) were expected to play a central role in the community-based referral system. Good or fair relationships with AH, CRU, GP, other STW/LTCF/IHCCS, the general community and the local authority were found in 63%, 42%, 52%, 54%, 49% and 24%, respectively. Medical/care information sharing was achieved in 8%/8% and not scheduled in 64%/61%. The proper assessment indicator for STW/LTCF by a third party was the measurement of rehabilitation function (47%). Conclusions: The main reasons for the difficulty in returning home for stroke patients in STW/LTCF are troublesome issues. At present, the information sharing for stroke patients in STW/LTCF remains unsatisfactory.
