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Net saving from early supported discharge

19 Sep 2014

Early Supported Discharge (ESD) should be the preferred rehabilitation option for patients with mild to moderate disability after stroke, a new report published by the Economic and Social Research Institute of Ireland (ESRI) and the Irish Heart Foundation has recommended.

Implementing such a policy for stroke survivors could save between €2 million and €7 million annually and free up more than 24,000 hospital bed days.

These savings from reduced acute bed days achieved by ESD should then be applied to resourcing community care staff: physiotherapists, occupational therapists, speech and language therapists, community nurses, social workers, home helps, psychologists and counsellors, the report recommends.

The ESRI- and RCSI-led research found that 54 per cent of stroke survivors — more than 3,000 people a year — could benefit from early supported discharge programmes.

According to the report, Towards Earlier Discharge, Better Outcomes, Lower Cost: Stroke Rehabilitation in Ireland, implementing ESD would require a substantial increase in the resourcing of community therapists, community nurses and other community care above current levels. However, savings from the reduced cost of acute bed days could fund this increase.

Dr Maev-Ann Wren, lead author of the report and senior research officer at the ESRI, said: “The analysis in this report supports a move to international best practice in stroke rehabilitation in Ireland, with the potential for better outcomes for patients from better care in the community. This could be achieved at a net saving in national health expenditure by freeing up acute hospital beds.”

A survey of hospital stroke lead clinicians found that severe stroke patients may experience long waits for nursing home care and for specialist inpatient rehabilitation. Thus suitable nursing home places should be increased, the report adds.

19 September 2014

Click here to view the full article which appeared in Irish Medical Times