title: [Opinions on the organisation of health care in strokes. A survey among hospital medical directors in Spain].
abstract: BACKGROUND
  Therapy to treat strokes has changed dramatically. Around 70 years ago, it could not be treated and today it is a medical emergency. Awareness of this change has still not reached many layers of the medical or health care professions or of society itself.
  
  
  OBJECTIVE
  To use a survey to evaluate the attitudes of medical directors and hospital specialists towards the problems involved in the inpatient care of stroke patients. Materials and methods. A survey was carried out by means of a pilot study in hospitals in Madrid with specific sub-surveys for medical managers in charge of neurology departments, neurosurgery services and stroke units. These surveys were sent out to 108 acute care hospitals with over 250 beds in 2003-2004.
  
  
  RESULTS
  Only the results of the survey administered by medical directors are analysed. Finally, 52 surveys were obtained from 108 hospitals. Information was collected about several aspects of stroke patients, including care in hospital emergency department, admission to hospital, rehabilitation treatment and staffing in stroke units. Care of stroke patients was given a significantly more positive score (better stroke care) by medical directors than by hospital neurologists.
  
  
  CONCLUSIONS
  The survey revealed a great care burden from stroke in hospital emergency departments and from hospital admissions, deficits in neurological duty services and in the capacity to perform fibrinolysis and, above all, in stroke units. The data obtained show that medical directors should improve their attitudes with regard to the care of stroke patients.
authors.affiliation: Servicio de Neurología, Hospital Universitario 12 de Octubre. Madrid, España. fbermejop2004@yahoo.es
authors.forename: F
authors.initials: F
authors.lastname: Bermejo-Pareja
authors.forename: P
authors.initials: P
authors.lastname: Iglesias-Casarrubios
authors.forename: P
authors.initials: P
authors.lastname: Calleja
authors.forename: P M
authors.initials: PM
authors.lastname: Ruiz-Lopez