Gothenburg Very Early Supported Discharge: evaluating differences in costs and environmental impact depending on the form of rehabilitation after stroke.

To evaluate the cost and environmental impact of rehabilitation consumption during the first year after discharge, in patients who were randomized to very early supported discharge (VESD) compared with patients who were discharged from hospital according to ordinary routines after stroke.

140 adult patients from a stroke unit at the Sahlgrenska University Hospital who were consecutively included in the GOTVED study and then randomized to VESD group or to a control group who received ordinary discharge was included. The term rehabilitation consumption was used to include all rehabilitation visits to outpatient hospital and primary care such as clinical examinations and rehabilitation post discharge from the hospital. The impact of inpatient care and rehabilitation on the environment has been estimated in kg CO₂, according to estimates from the National Health Services in England

The control group stayed in average 2 days longer in hospital compared to the VESD group resulting in a mean cost of 9824.8 EUR in the VESD group, and for the control group 10,741 EUR. 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=0.84). 

Our study shows that VESD service can be a sustainable alternative to ordinary discharge routines for patients with disability after stroke because it can reduce the cost and environmental impact of healthcare consumption while maintaining patients’ quality of life. 

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