Gothenburg very early supported discharge: evaluating differences in costs and environmental impact due to rehabilitation consumption during the first year in patients hospitalized due to mild stroke.

Abstract

Background: It has been showed that Early Supported Discharge could decrease the length of hospital stay and thus a cost saving alternative to conventional in-hospital stroke rehabilitation. This might lead to decreased environmental impact due to reduced need of in-hospital care but has not been evaluated.

Methods: One hundred forty adult patients from a stroke unit at the Sahlgrenska University Hospital who were consecutively included in the GOTVED study and then randomized to Very Early Supported Discharge (VESD) group or to a control group who received ordinary discharge was included. Descriptive data are presented as mean ± standard deviation (SD) or median and interquartile range (IQR), as appropriate. The chi-square test or Mann-Whitney U test was used to test for group difference. A two-sided value of p ≤ 0.05 was considered to represent statistical significance.

Results: The VESD group had an average hospital stay that was 2 days shorter than that of the control group, resulting in a mean cost of € 11,151 in the VESD group, and for the control group € 10,741 (p = 68). The mean environmental impact in kg CO₂ emissions was 525.3 (± 240.1) kg CO₂/patient in the VESD group, VESD visits included, and 552.5 (± 284.2) kg CO₂/patient in the control group (p = 0.55).

Discussion: Despite the fact that the 2-day difference in hospital stay between the VESD group and the control group was not statistically, if generalized a two days shorter in-hospital stay to all hospitalized stroke patients in Sweden, would results in a saving of € 6,944,500 /year. Two days shorter in-hospital days would also mean a reduction in CO₂ emissions with approximately 360,050 CO₂ kg /year. These hypothetical possible reductions in healthcare emissions would contribute to more sustainable healthcare.

Conclusion: A policy of offering more patients VESD after stroke could reduce healthcare costs and environmental impact, contributing to sustainable healthcare.

Trial registration: clinicaltrials.gov: NCT01622205, 2012-06-18 .