Stroke patients get little help to recover says survey

Rehabilitation for stroke sufferers in New Zealand hospitals is not up to scratch and needs urgent attention, a survey has found.

About 7000 people a year suffer strokes and fewer than half are alive and independent a year later.

In 2001 New Zealand had an estimated 32,000 stroke survivors. As the population ages, the number affected is expected to increase significantly.

The survey, published in the Medical Journal, canvassed all 48 hospitals.

They were asked about stroke patients' access to organised rehabilitation, management of common problems after a stroke and if the hospitals audited their services.

All hospitals responded to the survey, but 11 were excluded on the basis they did not routinely offer inpatient stroke rehabilitation because another hospital nearby did, or they were too small and referred patients to another hospital.

The survey found that only one hospital provided a dedicated inpatient stroke rehabilitation facility and only 57 per cent of the population had access to hospitals with a nominated lead clinician for stroke rehabilitation services.

Other findings included only 30 per cent of the population being served by hospitals with a multidisciplinary therapy team expert in stroke care, and only eight hospitals that had audited their stroke rehabilitation services.

"The development of an organised approach to stroke rehabilitation services must be seen as a priority," the survey authors said.

"Organised stroke care, especially early and co-ordinated rehabilitation in a stroke unit, unequivocally reduces both mortality and morbidity following stroke when compared with rehabilitation in general wards."

Another survey of acute stroke management had found that only four hospitals had organised, acute, inpatient care.

Twenty-three hospitals had a multidisciplinary team expert in stroke rehabilitation but in 13 of them the teams spent less than half their time caring for stroke patients.

Only five hospitals kept a stroke register and 13 hospitals did not routinely follow up patients or allow self-referral for review after their discharge.

Hospitals attributed their lack of services to several things such as limited beds, but most often pointed to a lack of specialised staff including psychologists, nurses, speech therapists, social workers, physiotherapists and occupational therapists.

"The major finding of [the latest] study is that most New Zealanders do not have access to stroke-specific, organised, inpatient stroke rehabilitation" despite clear evidence of its value.

- NZPA