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(Stroke. 2004;35:397.)
© 2004 American Heart Association, Inc.

Advances in Stroke 2003

Health Policy and Outcome Research in Stroke

Anthony G. Rudd, FRCP (Lond) David B. Matchar, MD

From the Clinical Effectiveness and Evaluation Unit (A.G.R.), Royal College of Physicians, London, UK; and the Center for Clinical Health Policy Research (D.B.M.), Duke University Medical Center, Durham, NC.

Correspondence to Dr David B. Matchar, Duke University Center for Clinical Health Policy Research, First Union Tower, Suite 230, 2200 W Main St, Box 90527, Durham, NC 27705. E-mail match001@mc.duke.edu

Key Words: Advances in Stroke • health policy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Health policy research seeks to inform clinical and public policy related to stroke prevention, treatment, rehabilitation, and long-term care. This review is not intended to be comprehensive but to highlight some of the recent studies that address important areas of stroke service provision.

Organized Stroke Care

We have just passed the 10th anniversary of the publication of the meta-analysis by Langhorne et al showing that stroke units save lives.¹ Since then further trials have reinforced this message showing that the benefits of organized stroke care are evident regardless of the type or severity of the stroke or the age of the patient. Of particular importance is the demonstration that the benefits are very long lasting. Reducing the odds of death by nearly 20% and death and dependency by nearly 30% stroke unit care is one of the most powerful interventions we currently have available and one that can be implemented without imposing a major financial burden on health care providers.² Despite this, the evidence from Europe suggests that few countries have succeeded in providing the majority of stroke patients with specialist care. In the United Kingdom only 36% of patients are managed at any time during their hospital stay on a stroke unit, in France 4%,³ Germany 30%⁴ and Italy 9%.⁵ Only in some of Scandinavian countries do figures approach acceptable levels with 60% in Norway and 70% in Sweden.

In England political pressure is being used to influence change within the health service. By April 2004 the Department of Health has stated . . . [Full Text of this Article]

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