Concentrating stroke care provision in the Czech Republic: The establishment of Stroke Centres in 2011 has led to improved outcomes

. 2021 Apr ; 125 (4) : 520-525. [epub] 20210130

Jazyk angličtina Země Irsko Médium print-electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid33558022

This article describes policy processes that have led to the re-organisation of stroke care in the Czech Republic since 2011, which has been part of a broader process of care concentration in several medical fields. Currently, stroke care is provided by 13 Comprehensive and 32 Primary Stroke Centres. The paper explains factors that supported the reform implementation, reviews implications, and discusses future challenges. Mandatory reporting of quality indicators, the introduction of a benchmarking system, integration with pre-hospital emergency care, and the introduction of countrywide patient triage have supported more timely treatment for stroke patients and better quality of care. Data from the Stroke Care Quality Indicators of the Czech Stroke Society show positive trends in many areas: the number of patients treated with intravenous thrombolysis quadrupled in eight years, with 26.4 % of all acute stroke patients receiving thrombolysis in 2018. Czech Republic now ranks third in Europe in the number of thrombolysis per population and second in the number of mechanical thrombectomies per population. The Czech experience provides an example of positive outcomes of concentrated stroke care, while highlighting the importance of proper implementation processes. In particular, it is essential to involve stakeholders and to provide reputational incentives through continuous benchmarking.

2nd Medical School of Charles University and Motol University Hospital Department of Neurology Prague Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

Agel Research and Training Institute Ostrava Vitkovice Hospital Neurology Ostrava Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

County Hospital Chomutov Neurology Chomutov Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

Department of Neurology Comprehensive Stroke Centre Charles University Faculty of Medicine and University Hospital in Hradec Králové Hradec Králové Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

Faculty of Social Sciences Charles University Opletalova 26 110 00 Prague Czech Republic

Hospital Jihlava Department of Neurology Jihlava Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

Palacký Medical School and University Hospital Comprehensive Stroke Center Department of Neurology Olomouc Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

St Anne's University Hospital and Faculty of Medicine Masaryk University Department of Neurology Brno Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

University Hospital Ostrava Department of Neurology Ostrava Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

University Hospital Ostrava Medical Faculty of Ostrava University Department of Neurology Ostrava Czech Republic; Executive Board of Czech Stroke Society Czech Neurological Society of the J E Purkyně Czech Medical Society Prague Czech Republic

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