[Reality of acute stroke patient care in the metropolitan Ruhr area: status quo and perspectives of a stroke-specific network].
BACKGROUND
Networking structures are constructed to improve daily care of acute stroke patients, in the Ruhr area by the association of 26 neurological departments. Quality of care can be measured by the rate of stroke unit treatment and of thrombolysis. Epidemiological data are mainly derived from registers resulting in sparse insight into incidence and rate of specialized care in daily practice.


METHODS
The study involved data analysis of diagnosis-related groups (DRG) statistics and structured quality reports for 2008 and 2010 for depiction of the quality of routine treatment. Aggregation of the number of cases for incidence, rate of stroke unit treatment and thrombolysis district, province, and nation wide were analyzed.


RESULTS
In 5.2 million inhabitants, the incidence of ischemic stroke (ICD I63) was 296/100,000 in 2010 (district-wise range 244-364) and 56% of patients were treated on a stroke unit (range 18-80%; 2008: 43%, range 10-72%). The rate of thrombolysis (ICD I63) was 6.4% and 9.1% in 2008 and 2010 (2008 range 0-11.2%, 2010 range 3.9-18.0%), respectively, which was significantly above the provincial average in 10 out of 15 districts.


CONCLUSIONS
Ischemic stroke is a common disease in the area and the quality of care (e.g. stroke unit treatment and thrombolysis rate) is above average. The heterogeneous character of the region allows an exemplary networking aiming for the improvement of routine patient care, e.g. by the implementation of homogeneous standards and structural measures for the implementation of novel therapies. The current analysis allows the identification of the potential for optimization and monitoring of any changes.
Klinik für Neurologie, Universitätsklinikum Knappschaftskrankenhaus Bochum, In der Schornau 23-25, 44892 Bochum, Deutschland. eyding@web.de
J
J
Eyding
M
M
Kitzrow
D
D
Bartig
H-U
HU
Sorgenfrei
C
C
Krogias
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019058:Community Networks / Q000706:statistics & numerical data*; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult