OBJECTIVE: To determine the functional outcome, location of care and economic consequences three months following hospitalization for first ischemic stroke. METHODS: As part of the Erlangen Stroke Project (ESPro), information was collected on patients diagnosed as having a stroke between April 1994 and March 1996. Barthel Index (BI), Functional Independence Measure (FIM) and location of care were determined three months after the stroke. A subset of eight items from the FIM was used to define patients as independent or dependent on caregivers. BI scores three months after the stroke were divided into three categories low (0-55), medium (60-90) and high (95-100). Data collected about health and social services used by these patients were combined with estimates of costs for these services in Germany. Costs were estimated in 2000 DM (1=$ 0.53USD, € 0.51), undiscounted. RESULTS: Information was recorded on 379 patients, half of whom had not fully recovered at 3 months (27% medium BI, 24% in low category). The majority (79%) was residing in the community, 43% remained dependent but 61% of them still returned to the community. Cumulative costs of care over 3 months for institutionalized patients with high BI were DM35, 100, and with medium BI DM55,000; about 1.5 fold those of patients in the same category residing in the community. Costs for patients with low BI were higher whether in the community (DM51,600) or in institutional care (DM53,400). CONCLUSION: Many patients were left with a level of disability that required a substantial amount of support from caregivers. In Germany, location of care has an impact on the economic consequences at higher levels of BI only.