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印度实施卒中护理和道路安全的经验教训:来自澳大利亚的经验。

Implementation of stroke care & road safety in India: Lessons from Australia.

机构信息

Department of Rehabilitation Medicine, Queen Elizabeth Hospital, Adelaide, Australia.

Department of Medicine, James Cook University, Douglas, Townsville, Australia.

出版信息

Indian J Med Res. 2024;159(3 & 4):267-273. doi: 10.25259/IJMR_274_2024.

Abstract

India is home to one-fifth of the world's population and is currently the fastest-growing economy. As the health industry is growing, India needs to develop robust implementation of evidence-based health care addressing the major public health issues. Two of such issues India is grappling with are the establishment of stroke care and the reduction of road accidents. Australia has achieved notable success in implementing stroke care and reducing road accidents. In stroke, Australian initiatives include dedicated stroke units, the development of clinical guidelines, the implementation of acute interventions, the establishment of a national stroke foundation, and the stroke registry. As a result, the combined, primary, and secondary prevention measures, acute treatment, and rehabilitation have reduced the total disease burden of stroke from 2003 to 2023 by 53 per cent, from 7.4 to 3.5 Disability Adjusted Life Years (DALYS) per 1,000 population, which is a 56 per cent decline in fatal burden and 23 per cent decline in non-fatal burden. For road safety, Australia implemented evidence-based practices such as education, legislation including mandatory use of seat belts, and other road safety initiatives. Data show that seat belt use reached 98 per cent in Australia in 2023. Furthermore, about 20 per cent of drivers as well as passengers who were killed in crashes in 2024 did not wear seat belts. The reduction of speed limits in built-up areas, the adoption of monitoring technology, and the clever use of infrastructure are proving to be effective in reducing fatalities and serious injuries. Australia's implementation research can provide valuable insights into the efforts of mitigating the impact of stroke and enhancing road safety in India.

摘要

印度拥有世界五分之一的人口,目前是增长最快的经济体。随着医疗保健行业的发展,印度需要大力实施基于证据的医疗保健,以解决主要的公共卫生问题。印度正在努力应对的两个问题是建立中风护理和减少道路事故。澳大利亚在实施中风护理和减少道路事故方面取得了显著成就。在中风方面,澳大利亚的举措包括专门的中风病房、制定临床指南、实施急性干预措施、建立国家中风基金会以及中风登记处。因此,综合、初级和二级预防措施、急性治疗和康复,使 2003 年至 2023 年中风的总疾病负担减少了 53%,每 1000 人残疾调整生命年(DALYs)从 7.4 减少到 3.5,致命负担下降了 56%,非致命负担下降了 23%。为了道路安全,澳大利亚实施了基于证据的实践,如教育、立法,包括强制使用安全带,以及其他道路安全举措。数据显示,2023 年澳大利亚安全带使用率达到 98%。此外,2024 年在撞车事故中死亡的司机和乘客中,约有 20%没有系安全带。在市区降低限速、采用监测技术以及巧妙利用基础设施,事实证明这些措施在减少死亡和重伤方面非常有效。澳大利亚的实施研究可以为印度减轻中风影响和加强道路安全的努力提供宝贵的见解。

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本文引用的文献

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Implementation science: What is it and why should I care?实施科学:它是什么,为什么我应该关心?
Psychiatry Res. 2020 Jan;283:112376. doi: 10.1016/j.psychres.2019.04.025. Epub 2019 Apr 23.
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Global Burden of Stroke.全球卒中负担。
Semin Neurol. 2018 Apr;38(2):208-211. doi: 10.1055/s-0038-1649503. Epub 2018 May 23.

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