Hospital-based stroke rehabilitation in the United States.

In this article, we consider (1) the role of Medicare in shaping US inpatient rehabilitation facility (IRF) stroke rehabilitation, (2) admission criteria for IRF care in the United States and medical management while in IRF, (3) the organization and delivery of IRF-level nursing and therapy, (4) post-IRF rehabilitation choices, (5) monitoring of rehabilitation outcomes, and (6) the implications of a multisite stroke outcome study for stroke rehabilitation practice. Inpatient stroke rehabilitation in the United States is a team-oriented, patient-centered, Medicare-driven service provided to stroke survivors. As a field of practice, it strives for continuous quality improvement to optimize patient outcomes. Stroke rehabilitation as a science, however, remains underfunded relative to the scope of the challenge in Western societies and worldwide for that matter. Worldwide sharing of best practices found in the United States and other countries will allow stroke survivors of any country improved chances for functional recovery, greater independence, and life satisfaction.