Post-stroke rehabilitation in Italy: inconsistencies across regional strategies

Population. All decrees and resolutions as to post-acute stroke rehabilitation were collected from each Italian region.Method. All decrees and resolutions were examined by the means of a check list including quantitative and qualitative characteristics, selected in accordance with national of!cial recommendations. Each completed check list was then sent to each regional reference person, who !lled in the section on the implementa-tion of the indications and compliance.Results. The study was carried out from November 2009 to September 2010. The documents were collect-ed from 19 out of the 20 Italian regions. The results of the study indicate that there are many, remarkable regional variations in health policies concerning post-stroke care. Instruments for evaluation and criteria for allocating stroke patients to proper rehabilitation setting vary across regions, but data on the potential impact of these variations on clinical outcomes are still lacking.Conclusion. The study highlights the issue that, in Italy, delivery of post-stroke rehabilitation services is not uniform nation-wide and varies substantially across regions. The lack of a comprehensive post-acute stroke strategy is a major obstacle to service availability.