What are the benefits of acute inpatient rehabilitation for middle cerebral artery (MCA) stroke?

Updated: Feb 20, 2018
  • Author: Daniel I Slater, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

In this period of increasing financial scrutiny and increased use of evidence-based medicine, comparison of postacute rehabilitation settings is growing more robust. Acute, inpatient rehabilitation facilities generally deliver more hours of and greater interdisciplinary care for stroke patients. However, the cost of rehabilitation delivered per patient from these facilities has been found to be around twice as expensive ($12,320) when compared with subacute or skilled nursing facilities ($6215). [95] Highly complex and prolonged stroke care, such as mechanical ventilation, is often achieved in long-term acute care facilities and obviously is more expensive.

Regardless, acute rehabilitation, compared with rehabilitation at a skilled nursing facility, does appear to result in lower mortality, decreased hospital re-admission, higher likelihood of return home in the short and longer term, and greater improvement in motor and cognitive function. [96, 97]

The Centers for Medicare and Medicaid Services do approve and fund admission for their covered patients to acute rehabilitation, so long as successful discharge home can be achieved in a reasonable period (approximately 2-3 wk).


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