Europe; epidemiology; stroke; stroke care; stroke services; stroke treatment; Humans; Europe/epidemiology; Delivery of Health Care; Stroke/therapy; Stroke/epidemiology; Healthcare Disparities; Neurology (clinical); Cardiology and Cardiovascular Medicine
Abstract :
[en] [en] INTRODUCTION: Inequity in stroke care in Europe has previously been reported despite the existence of evidence-based cost-effective interventions for both prevention and treatment. This report aims to provide comprehensive data on stroke care in Europe in 2023 and explore associations to European regions, organisational and economic factors.
PATIENTS AND METHODS: The Stroke Service Tracker, an annually collected survey-based dataset of aggregate summary data from participating European nations, was used with key performance indicators (KPIs) from the Stroke Action Plan for Europe (SAP-E). European regions were defined based on United Nations Geoscheme regions. Gross domestic product (GDP) per capita and healthcare spending per capita were collected based on World Bank data.
RESULTS: A total of 1,460,630 stroke events were reported in 2023 from 52 nations. Significant inequity was present in all data points and data quality varied significantly. Twenty (43.5%) nations have a national stroke plan in place, and in 19 (41.3%) work is ongoing. Quality programmes have been implemented in 20 (43.5%) nations. Implementation of a national stroke plan or a quality programme was associated with achieving more SAP-E KPIs (P < .001). There were regional differences in the number of met KPIs (P < .001). Both GDP and healthcare spending per capita were strongly correlated to meeting KPIs.
CONCLUSION: The inequity in stroke care persists in Europe. Implementation of a national stroke plan and a quality programme is associated with meeting more KPIs; however, economic factors may pose limitations. Access to high-quality data will support decision-making towards evidence-based and cost-effective care.
Disciplines :
Neurology
Author, co-author :
Christensen, Hanne ; Department of Neurology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
Pezzella, Francesca Romana ; Neurosciences Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
Roaldsen, Melinda Berg; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway ; Clinical Research Department, University Hospital of North Norway, Tromsø, Norway
Tomek, Ales ; Department of Neurology, Motol University Hospital, Prague, Czech Republic
Ovesen, Christian ; Department of Neurology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
Wilkie, Arlene; Stroke Alliance for Europe, Brussels, Belgium
Budincevic, Hrvoje ; Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia ; Department of Neurology and Neurosurgery, Faculty of Medicine Osijek, Osijek, Croatia
Dichgans, Martin ; Institute for Stroke and Dementia Research, LMU Munich, Munich, Germany
Fischer, Urs ; Department of Neurology, University Hospital Bern, Bern, Switzerland
Grundtvig, Josefine; Department of Neurology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
Kelly, Peter; Department of Neurology, Mater Misericordiae University Hospital, Dublin, Ireland ; Stroke Clinical Trials Network Ireland, Catherine McAuley Centre, Dublin, Ireland
Lunde, Grethe; Stroke Alliance for Europe, Brussels, Belgium
Macey, Chris; Stroke Alliance for Europe, Brussels, Belgium
Mikulik, Robert ; Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic
Rosenørn, Amira; Department of Neurology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
Santo, Gustavo; Department of Neurology, University Hospital of Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
de Sousa, Diana Aguiar; Stroke Center, University Hospital Center of Central Lisbon, Lisbon, Portugal ; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Tiu, Cristina; Department of Neurology, University Hospital Bucharest, Bucharest, Romania ; Department of Clinical Neurosciences, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Sacco, Simona ; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Vilionskis, Aleksandras; Clinic of Neurology and Neurosurgery, Vilnius University, Vilnius, Lithuania
Norrving, Bo; Department of Clinical Sciences, Lund University, Lund, Sweden
SAP-E collaborators
Delvoye, François ; Université de Liège - ULiège > Département des sciences cliniques ; Université de Liège - ULiège > GIGA > GIGA Metabolism & Cardiovascular Biology - Cardiology ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie
