POSTSTROKE REHABILITATION - AN ECONOMIC OR MEDICAL PRIORITY - CURRENTISSUES AND PROSPECTS IN LIGHT OF NEW LEGISLATIVE REGULATIONS

The aim of this study was to evaluate: 1) whether the reduction in dur ation of in-patient rehabilitation imposed by the Italian Ministry of Health's circular of 29/6/95 has been accompanied by a decline in the results achieved; and 2) whether the system of basing payments on diag nosis related group (DRG) criteria is capable of correctly evaluating differences in post-stroke clinical pictures. The study involved 461 o f 497 patients consecutively admitted between 1991 and 1996 for rehabi litation after a first stroke. The average duration of hospitalisation for the period 1995-1996 was significantly shorter (p<0.001) than tha t of the previous years; at the same time, there was a significant inc rease (p<0.05) in the number of poor responders in both neurological a nd functional (mobility) terms. Furthermore, the early discharge after 60 days of the 1995-1996 patients compromised the stabilisation of re covery and led to a subsequent functional decline. It is therefore hop ed that the current regulations will be revised and that payments base d on a functional related group (FRG) criterion will be introduced.