AIM: To investigate the effects of three-stage rehabilitation program including the department of neurology in the First Class of Third Level Hospital, rehabilitative center /department of rehabilitation of general hospital and medical organization in community/family rehabilitation, on functional recovery of patients with acute stroke and make the relevant cost-effectiveness analysis. METHODS: Totally 70 patients with stroke diagnosed by CT or MRI and admitted in First People's Hospital of Shanghai Jiaotong University were selected and randomly divided into rehabilitative group and control group with 35 cases in each group. (1) Besides the routine treatment in the Department of Neurology, the patients in the rehabilitative group were given one to one rehabilitative training for 6 months by the rehabilitative physician: The training was performed in the ward in the 1st month of the disease, once daily, 45 minutes every time at the 2nd stage of the 2nd and 3rd months and the 4th to 6th month of disease, the patients were transferred to Department of Rehabilitation of general hospital for treatment (second grade rehabilitation) according to their condition and functional recovery state, twice to three times every week, 45 minutes every time or transferred home and guided by the doctors twice every week to help the patients do some necessary functional training until finishing the follow up (third grade rehabilitation). The patients in the control group were not given any regular rehabilitative training. (2) All patients were evaluated by the same doctor with Fugl-Meyer Motor Assessment (FMA), Modified Barthel Index (MBI), Function Comprehensive Assessment (FCA) and Cognitive Function Score (CFS) and Neurological Deficit Score (NDS, the higher the scores of NDS, the severer the disease (the high scores in other evaluation represented the function was improved) at admission, 1, 3 and 6 months after stroke, respectively. The expenses including direct medical expense, direct nonmedical expense, indirect expense and so on of the two groups were compared and concluded with the method of cost-effectiveness analysis. RESULTS: All the 70 cases were involved in the result analysis. (1) The scores in FMA, MBI, FCA and CFS of the rehabilitative group were higher that the control group, but the scores of the NDS were significantly lower than the control group (p < 0.01). (2) There was no significant difference in the drug cost, total cost of hospitalization and direct medical cost between rehabilitative group and control group (p > 0.05), the mean value of regular rehabilitative expense of the rehabilitative group was 962.18 Yuan, account for 6% of the medical expense. (3) By one score that FMA, MBI, FCA and NDS improved, the direct medical cost in the rehabilitative group was 322.12, 288.51, 399.39 and 1 166.88 Yuan, respectively, while in the control group was 637.49, 453.35, 715.14 and 1 911.22 Yuan, respectively. CONCLUSION: Three-stage rehabilitation program can better improve the functional recovery of patients with stroke and has favorable economic effect.

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