World Federation of Neurology, Chester House, 83 Fulham High St, London SW6 3JA, London, UK; Department of Neurology, Sir Charles Gairdner Hospital Perth, Western Australia, 6009, University of Western Australia, Centre for Neuromuscular and Neurological Disorders Perron Institute, 8 Verdun St. Nedlands WA, 6009, Australia.
World Federation of Neurology, Chester House, 83 Fulham High St, London SW6 3JA, London, UK; Medical University of Vienna, Ludwig Boltzmann Institute for Experimental und Clinical Traumatology Donaueschingenstraße, 13 A-1200 Wien, Austria.
J Neurol Sci. 2024 Oct 15;465:123124. doi: 10.1016/j.jns.2024.123124. Epub 2024 Jul 4.
The WFN Needs Registry survey was developed and conducted over two and a half years commencing in 2020 to investigate the accessibility and affordability of neurological services and therapeutics and the most urgent needs.
An experienced neurologist responded in each of 118 societies to an online electronic survey comprising 13 questions. General data sought comprised the respondent's training, place of practice, duration in practice, number of neurologists in the society, health care system and types of neurological practice available. Specific data collected comprised neurological facilities, specialist services available, resources, therapeutics accessibility, challenges and three most urgent needs.
Responding neurologists spent a median of 26 years in practice and represented a median of 225 neurologists per society. Of 13 classes of neuromedicines deemed readily available to 70% of the population, 41 societies listed ≥1 and 14 societies ≥3 unavailable. The three most frequent unavailable neuromedicines were second level AEDs, Dopamine agonists and MS DMTs. Of 14 neurological services, 15 societies had all services accessible and affordable, 13 had none and 72 had ≥1 services either inaccessible or unaffordable. EEG, Epilepsy, Headache and EMG services were most available; Neurogenetics, Neuropsychology, Neurorehabilitation and Neurodevelopmental services were least available. Of 13 specified challenges, lack of subspecialists and specialty centers were both identified by 61% of societies followed by costs of neurological care, neuromedicines availability and stigma. Ten societies had no challenges.
A unique insight into the inequities of neurological care globally and a potential tool to assist their remedy.
世界神经病学联盟（WFN）需求登记调查历经两年半时间，于 2020 年展开，旨在调查神经科服务和治疗的可及性和可负担性，以及最紧迫的需求。
118 个学会中的每一位经验丰富的神经病学家都对包含 13 个问题的在线电子调查问卷做出回应。调查内容包括应答者的培训、执业地点、执业年限、学会中的神经病学家人数、医疗保健系统和可用的神经科实践类型等一般信息。收集的具体信息包括神经科设施、可用的专科服务、资源、治疗方法的可及性、挑战以及最紧迫的三个需求。
应答的神经病学家平均执业时间为 26 年，每个学会平均有 225 名神经病学家。在被认为可广泛获得的 13 类神经药物中，有 41 个学会列出了≥1 种不可获得的药物，14 个学会列出了≥3 种不可获得的药物。最常出现的三种不可获得的神经药物是二线抗癫痫药、多巴胺激动剂和多发性硬化症 DMT。在 14 项神经科服务中，15 个学会的所有服务都可及且负担得起，13 个学会的所有服务都不可及或负担不起，72 个学会的≥1 项服务不可及或负担不起。EEG、癫痫、头痛和肌电图服务最易获得；神经遗传学、神经心理学、神经康复和神经发育服务最不易获得。在 13 项指定的挑战中，缺乏专科医生和专业中心均被 61%的学会识别出来，其次是神经科护理费用、神经药物的可及性和污名。有 10 个学会没有遇到挑战。
该研究提供了对全球神经科护理不平等现象的独特见解，是协助解决这些不平等现象的潜在工具。
