Stroke Rehabilitation Services In New Zealand: A Survey Of Service Configuration, Capacity And Guideline Adherence

Aim To provide an up-to-date account of stroke rehabilitation services in all District Health Boards (DHB) in New Zealand in 2013.Method An online survey was completed by clinicians at all 38 facilities in New Zealand providing rehabilitation services following acute stroke.Results There was some evidence of stroke rehabilitation specialisation, particularly in larger DHBs (seven of eight large DHBs provided a dedicated stroke rehabilitation unit or designated beds). Capacity was generally satisfactory with units accommodating all (68% of units) or most (further 29%) of stroke patients needing rehabilitation. Most units had guidelines for the management of common problems following stroke, apart from depression screening (7%), but intensity of therapy input remains below recommended levels. Post-discharge rehabilitation services are available in the majority of areas but significant delays (mean 14 days) are common in accessing these services. The results for New Zealand stroke rehabilitation services are broadly comparable with those from the recent Australian stroke rehabilitation service audit.Conclusion Compared to previous surveys, New Zealand stroke rehabilitation services have shown progress. To maximise outcomes for stroke patients, improvements are still needed in provision of dedicated stroke rehabilitation units, rehabilitation intensity and access to prompt community rehabilitation in the community.