Cadilhac D A, Lalor E E, Pearce D C, Levi C R, Donnan G A
National Stroke Research Institute, Repatriation Hospital, Heidelberg Heights, Victoria, Australia.
Intern Med J. 2006 Nov;36(11):700-4. doi: 10.1111/j.1445-5994.2006.01168.x.
There is level I evidence that management of stroke patients in stroke units (SU) improves outcomes (death and institutionalization) by approximately 20%. In Australia, there is uncertainty as to the proportion of incident cases that have access to SU. Recent national and State-based policy initiatives to increase access to SU have been taken. However, objective evidence related to SU implementation progress is lacking. The aims of the study were (i) to determine the number of SU in Australian acute public hospitals in 2004, (ii) to describe hospitals according to national SU policy criteria and (iii) to compare results to the 1999 survey to track progress.
The method used in the study was a cross-sectional, postal survey technique. The participants were clinical representatives considered appropriate to describe stroke care within survey hospitals.
The outcome of the study was presence of a SU according to an accepted definition. Response rate was 261/301 (87%). Sixty-one sites (23%) had either a SU and/or a dedicated stroke team. Fifty sites claimed to have a SU (19%). New South Wales with 23 had the most number of SU. Based on policy criteria, up to 64 sites could have a SU. In 1999, there were 35 public hospitals with a SU.
Access to SU in Australian public hospitals remains low compared with other countries (Sweden, 70%). Implementation strategies supported by appropriate health policy to improve access are needed.
有一级证据表明，在卒中单元（SU）对卒中患者进行管理可使预后（死亡和机构收容）改善约20%。在澳大利亚，能使用卒中单元的新发病例比例尚不确定。近期已采取了基于国家和州的政策举措以增加对卒中单元的使用。然而，缺乏与卒中单元实施进展相关的客观证据。本研究的目的是：（i）确定2004年澳大利亚急性公立医院中卒中单元的数量；（ii）根据国家卒中单元政策标准描述医院情况；（iii）将结果与1999年的调查进行比较以追踪进展。
本研究采用的方法是横断面邮政调查技术。参与者是被认为适合描述调查医院内卒中护理情况的临床代表。
研究结果是根据公认定义确定卒中单元的存在情况。回复率为261/301（87%）。61个机构（23%）设有卒中单元和/或专门的卒中团队。50个机构声称设有卒中单元（19%）。新南威尔士州有23个，拥有卒中单元的数量最多。根据政策标准，多达64个机构可以设有卒中单元。1999年，有35家公立医院设有卒中单元。
与其他国家（瑞典为70%）相比，澳大利亚公立医院中能使用卒中单元的比例仍然较低。需要有适当卫生政策支持的实施策略来改善可及性。
