Postacute care of stroke patients after the stroke unit - Aid for planningneurological rehabilitation

An increasing number of Stroke Units have been implemented in Departments o f Neurology over the past few years, in Germany, these Stroke Units are dev oted to the acute treatment of stroke and are therefore different from the Scandinavian and British Stroke Units which offer acute care and rehabilita tion services. The model of acute Stroke Units was developed because German y has a dense network of well staffed and equipped rehabilitation hospitals in all parts of the country. Transferring patients from acute Stroke Units to subacute care facilities may cause discontinuity of optimal treatment. This paper describes different levels of postacute treatment with respect t o severity of stroke, and attempts to establish an algorithm that may assis t in selecting the appropriate institution for rehabilitation. Following ac ute Stroke Unit treatment, criteria for selection of a rehabilitation facil ity include severity of stroke, need for medical services, and socioeconomi c factors.