J 2021

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

BRYNDOVA, Lucie; Michal BAR; Roman HERZIG; Robert MIKULÍK; Jiri NEUMANN et al.

Basic information

Original name

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

Authors

BRYNDOVA, Lucie; Michal BAR; Roman HERZIG; Robert MIKULÍK; Jiri NEUMANN; Daniel SANAK; Ondrej SKODA; David SKOLOUDIK; Daniel VACLAVIK and Ales TOMEK

Edition

Health Policy, Dorchetser UK, The Dorset Press, 2021, 0168-8510

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30304 Public and environmental health

Country of publisher

Ireland

Confidentiality degree

is not subject to a state or trade secret

References:

Impact factor

Impact factor: 3.255

Marked to be transferred to RIV

Yes

RIV identification code

RIV/00216224:14110/21:00121434

Organization unit

Faculty of Medicine

EID Scopus

Keywords in English

Stroke; Highly specialized care concentration; Quality monitoring; Benchmarking; Recanalization therapy

Tags

Changed: 21/4/2021 09:41, Mgr. Tereza Miškechová

Abstract

In the original language

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. 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 Indica-tors 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 pop-ulation 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. (c) 2021 Elsevier B.V. All rights reserved.