Abstract
Background and purpose: Emphasis is currently placed on the importance of the community-based care for stroke patients provided by acute hospitals (AH), convalescent rehabilitation wards (CRW), general practices (GP), long-term care facilities (LTCF) and in-home and commuting care services (IHCCS). We conducted a nationwide questionnaire survey to evaluate the role of AH in stroke care.
Subjects and Methods: In total, 12 representative prefectures were selected based on their population density. Questionnaires concerning the community-based referral system and long-term care insurance system were sent to all 2,185 AH.
Results: Forty-six percent of the hospitals answered. Fifty-two percent were engaged in medical practice for stroke patients. The major assessment scales for ADL were the Barthel Index (41%), the modified Rankin Scale (39%), and the simple ADL scale for long-term care insurance (41%). AH (69%) were expected to play a central role in the community-based care system. Good or fair relationships with other AH, CRW, GP, STW/LTCF/IHCCS, the overall community and the municipal corporation were found in 75%, 75%, 74%, 69%, 73% and 34%, respectively. Medical/care information sharing was achieved in 20%/14%, and planned in 51%/51%. Many problems were identified in the cooperation system with medical and long-term care insurances.
Conclusions: AH play a central role in the community-based referral system for stroke care. Although more than half of the AH have already planned information sharing, the situation remains inadequate at present.
