title: Organization of acute stroke services in Poland - Polish Stroke Unit Network development.
abstract: OBJECTIVE
  According to the recommendations of stroke organizations, every stroke patient should be treated in a specialized stroke unit (SU). We aimed to evaluate the development of the SU network in Poland during the past decade.
  
  
  METHODS
  In Poland, stroke is treated mainly by neurologists. A questionnaire evaluating structure and staff of neurological departments was sent to all neurological departments in 2003, 2005 and 2007. In 2010, we collected data based on information from the National Health Fund. We divided departments into categories: with a comprehensive SU, with a primary SU unit, and departments without an SU. Primary SUs were further divided into class A SUs (fulfilling criteria of the National Programme of Prevention and Treatment of Stroke Experts - eligible for thrombolysis), class B (conditionally fulfilling criteria), and class C (not fulfilling criteria).
  
  
  RESULTS
  Final analyses included 87.4% of departments (194/222) in 2003, 85.5% of departments (188/220) in 2005, and 83.1% of departments (182/219) in 2007. According to the above-mentioned classification there were 20 class A SUs in 2003, 58 in 2005 and 5 comprehensive and 51 class A SUs in 2007. In 2012, based on information from the National Health Fund there were 150 SUs, all fulfilling criteria for thrombolysis, 9 of them comprehensive SUs.
  
  
  CONCLUSIONS
  The SU network in Poland is developing dynamically but thrombolysis and endovascular procedures are done too rarely. Now it is necessary to improve quality of stroke services and to make organizational changes in the in-hospital stroke pathways as well as to organize continuous education of medical staff.
authors.affiliation: Instytut Psychiatrii i Neurologii, II Klinika Neurologii, Warszawa, Poland. idlugosz@ipin.edu.pl
authors.forename: Iwona
authors.initials: I
authors.lastname: Sarzyńska-Długosz
authors.forename: Marta
authors.initials: M
authors.lastname: Skowrońska
authors.forename: Anna
authors.initials: A
authors.lastname: Członkowska
mesh_terms: D000208:Acute Disease; D003422:Critical Care / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006752:Hospital Planning / Q000458:organization & administration; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D011044:Poland; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D015912:Thrombolytic Therapy; D014187:Transportation of Patients / Q000458:organization & administration