In his letter, Dr Meinck points out what he perceives to be two methodological limitations of our study. We would like to respond to these two items as follows.
- There is always a possibility that in individual cases, a patient does not actually embark on a rehabilitation treatment that has already been initiated during the acute treatment phase. However, this situation constitutes an exception in the context of the data reported on subsequent rehabilitation in the quality assurance project “Stroke Register Northwest Germany.” Data on rehabilitation treatments are reported only if these measures have already been planned and/or initiated by the acute care hospital. They thus refer to the cases where the hospital made a case for the rehabilitation treatment and/or has already undertaken steps towards its implementation.
- It is correct that no further differentiation of the different forms of geriatric rehabilitation was undertaken. We assume, however, that early rehabilitation treatments delivered in geriatric wards were also documented as “geriatric rehabilitation.” In case of uncertainty regarding the classification, an option existed to classify a measure as “other rehabilitation treatment”, so that we assume that there was no systematic underreporting of planned rehabilitation treatments. The data from the 11 participating neurology hospitals in the federal state of Thuringia do not indicate any underreporting of geriatric rehabilitation – for instance by comparison with hospitals in the Western German federal states. The hospitals in Thuringia delivered geriatric rehabilitation treatments to some 13% of all ischemic stroke patients in 2010 and 2011. The corresponding proportions for Lower Saxony and North Rhine–Westphalia are about 7% and 11%, respectively.
Dipl.-Psych. Michael Unrath, M.Sc.
Dr. rer. nat. Marianne Kalic
Prof. Dr. med. Klaus Berger, MPH, M. Sc.
Institut für Epidemiologie und Sozialmedizin,
Westfälische Wilhelms-Universität, Münster
Conflict of interest statement:
The authors declare that no conflict of interest exists.
|1.||Unrath M, Kalic M, Berger K: Who receives rehabilitation after stroke? Data from the quality assurance project “Stroke Register Northwest Germany”. Dtsch Arztebl Int 2013; 110(7): 101–7 VOLLTEXT|