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(Stroke. 2009;40:e301.)
© 2009 American Heart Association, Inc.

Advances in Stroke 2008

Advances in Health Policy and Outcomes

From the Royal College of Physicians (A.G.R.), London, UK; and the IU School of Medicine (L.S.W.), Indianapolis, Ind.

Correspondence to Anthony G. Rudd, FRCP (London), Programme Director for Stroke, Clinical Standards Department, Royal College of Physicians, 11 St Andrews Place, London NW1 4LE, UK. E-mail Anthony.rudd@kcl.ac.uk

Key Words: Health Policy • outcomes • Advances

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

	Introduction

 
Many countries seem at last to be taking stroke seriously, recognizing that it is a treatable disease and that failing to treat it effectively results in unnecessary suffering and a huge waste of health service resources. However, too many patients in high, low, and middle income countries still receive inadequate care. Rates of thrombolysis in most countries are still below 1% and in only a few countries is there more than a 50% chance that a patient will be treated in a specialized stroke unit. Access to brain imaging is often too slow and rehabilitation, particularly after the acute phase, is frequently absent or lacking in the necessary quantity or quality.^1,2 Recognition that there is a need for central planning, which should be done as a collaborative effort between clinicians, healthcare planners and politicians, is described in the essay by Larry Goldstein³ using the United States experience of policy development for stroke at a national and state level. He stresses the importance of clinicians being willingly engaged in the process to provide high quality information and expertise. George et al⁴ identify the importance of the components of a public health strategy designed to improve the quality of stroke care at a state level. The key issues are provision of leadership through policy development and assurance, sharing of information with providers, building capacity for conducting quality improvement activities and providing evidence-based guidelines, policies and plans as well as developing and enforcing laws and regulations to ensure the quality of stroke care. . . . [Full Text of this Article]