Three years of the nationwide post-acute stroke care program in Taiwan

Abstract

Prolonged hospital stay and readmission are prevalent problems for stroke patients in Taiwan after the acute stage, partly due to the unmet need of post-acute care. In March 2014, Taiwan's National Health Insurance Administration launched a nationwide Post-Acute Care-CerebroVascular Disease (PAC-CVD) program. The Taiwan Stroke Society, coordinating 11 allied disciplines, took responsibility for the preparation and implementation of the program. As of June 2016, 6839 consecutive stroke patients were enrolled. On discharge from the PAC program, the functional status had improved in 87.5% of patients, with a significant decrease in the mean modified Rankin Scale score from 3.7 to 3.0. The rates of readmission and mortality in the PAC group were also lower than in the control group. In conclusion, the Taiwan's PAC-CVD program is an innovative and essentially effective national program of post-acute stroke care. We believe such experience should be helpful for policy makers of stroke care worldwide.

Keywords: Stroke; Subacute care; Taiwan.