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Stroke units in Italy.

L Candelise1, A Bersano

  • 1Dipartimento di Scienze Neurologiche, Milan, Italy. livia.candelise@unimi.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|June 6, 2006
PubMed
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Stroke Units (SUs) improve patient care, but national coverage remains low at 10%. Despite an increase in SUs, regional disparities and a shortage of beds persist, highlighting the need for better stroke care organization.

Area of Science:

  • Neurology
  • Healthcare Management
  • Public Health

Background:

  • Stroke is a leading cause of morbidity and mortality.
  • Previous evidence supports the benefit of specialized Stroke Unit (SU) care.
  • Prior surveys documented SU coverage in seven Italian regions (2000-2001).

Purpose of the Study:

  • To conduct a recent national survey of Stroke Units (SUs) in Italy.
  • To evaluate changes in SU numbers and organization since 2000-2001.
  • To assess in-hospital stroke care organization across Italy.

Main Methods:

  • Identified hospital services using diagnosis-related groups (DRG 14) from national registers.
  • Selected services with at least 50 acute stroke discharges annually.
  • Collected data via phone questionnaires administered by trained researchers to service directors.

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  • Defined SUs as wards with dedicated beds and staff for acute stroke patients.

    • Main Results:

    • In 2003-2004, 68 out of 676 evaluated services (10%) were SUs.
    • National SU coverage ranged from 0% to 50% across regions.
    • SUs admitted 10% of total national acute stroke cases.
    • SUs demonstrated better organization and access to diagnostics compared to general wards.
    • Between 2000 and 2004, SU coverage increased from 7% to 11% in the initial seven regions.

    Conclusions:

    • Despite a 30% increase in SUs in previously evaluated regions, a shortage of SU beds persists.
    • Significant regional heterogeneity in SU coverage and organization remains a challenge.
    • Further efforts are needed to expand SU availability and standardize stroke care nationally.