Ministry of Health of the Republic of Poland, Miodowa 15, 00-952 Warsaw, Poland.
1st Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
Neurol Neurochir Pol. 2020;54(5):449-455. doi: 10.5603/PJNNS.a2020.0066. Epub 2020 Sep 4.
Selected and basic indicators of acute ischaemic stroke care in Poland are reported cross-regionally based on the analysis of claims data of the National Health Fund (NFZ) in 2017, the most reliable source of healthcare funding in the country, being a single public payer. For research purposes, a selection algorithm based on the diagnosis coded as I63 according to the International Classification of Diseases (ICD-10) was used to identify all ischaemic stroke patients in the claims database provided by the NFZ. Stroke units and other centres providing treatment for acute ischaemic stroke patients were examined. The analysis showed marked differences between provinces in terms of stroke unit treatment availability. The crude and standardised rates of acute ischaemic stroke admissions to stroke units varied between provinces. Moreover, substantial differences were observed for the thrombolysis implementation rate, access to rehabilitation, hospital stay and early prognosis. As the leading cause of disability and the second leading cause of death in developed countries, stroke requires a well-organised, evidence-based healthcare system provided for both acute treatment and rehabilitation. Continuous monitoring of healthcare is crucial to identify weaknesses and areas for improvement.
波兰在全国健康基金(NFZ)2017 年的理赔数据分析的基础上,进行了跨地区的急性缺血性脑卒中治疗的选择和基本指标报告,该基金是该国最可靠的单一公共支付者,也是医疗保健资金的主要来源。出于研究目的,根据国际疾病分类(ICD-10)编码为 I63 的诊断,使用选择算法从 NFZ 提供的理赔数据库中识别所有缺血性脑卒中患者。研究检查了卒中单元和其他为急性缺血性脑卒中患者提供治疗的中心。分析表明,各省份之间在卒中单元治疗的可及性方面存在显著差异。卒中单元收治急性缺血性脑卒中患者的粗率和标准化率在各省份之间存在差异。此外,溶栓实施率、康复机会、住院时间和早期预后也存在显著差异。作为发达国家中导致残疾的主要原因和死亡的第二大原因,卒中需要一个组织良好的、基于证据的医疗保健系统,为急性治疗和康复提供服务。持续监测医疗保健至关重要,有助于发现弱点和改进领域。