open access
Differences in acute ischaemic stroke care in Poland: analysis of claims database of National Health Fund in 2017
Affiliations- Ministry of Health of the Republic of Poland, Miodowa 15, 00-952 Warsaw, Poland
- 1st Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Interventional Stroke and Cerebrovascular Disease Treatment Centre, Institute of Psychiatry and Neurology, Warsaw, Poland
- Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
- Warsaw School of Economics, Social Insurance Department, Warsaw, Poland
- Department of Adult Neurology, Medical University of Gdansk, Poland
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland
open access
Abstract
Selected and basic indicators of acute ischaemic stroke care in Poland are reported cross-regionally based on the analysis of claims data of the National Health Fund (NFZ) in 2017, the most reliable source of healthcare funding in the country, being a single public payer. For research purposes, a selection algorithm based on the diagnosis coded as I63 according to the International Classification of Diseases (ICD-10) was used to identify all ischaemic stroke patients in the claims database provided by the NFZ. Stroke units and other centres providing treatment for acute ischaemic stroke patients were examined. The analysis showed marked differences between provinces in terms of stroke unit treatment availability. The crude and standardised rates of acute ischaemic stroke admissions to stroke units varied between provinces. Moreover, substantial differences were observed for the thrombolysis implementation rate, access to rehabilitation, hospital stay and early prognosis. As the leading cause of disability and the second leading cause of death in developed countries, stroke requires a well-organised, evidence-based healthcare system provided for both acute treatment and rehabilitation. Continuous monitoring of healthcare is crucial to identify weaknesses and areas for improvement.
Abstract
Selected and basic indicators of acute ischaemic stroke care in Poland are reported cross-regionally based on the analysis of claims data of the National Health Fund (NFZ) in 2017, the most reliable source of healthcare funding in the country, being a single public payer. For research purposes, a selection algorithm based on the diagnosis coded as I63 according to the International Classification of Diseases (ICD-10) was used to identify all ischaemic stroke patients in the claims database provided by the NFZ. Stroke units and other centres providing treatment for acute ischaemic stroke patients were examined. The analysis showed marked differences between provinces in terms of stroke unit treatment availability. The crude and standardised rates of acute ischaemic stroke admissions to stroke units varied between provinces. Moreover, substantial differences were observed for the thrombolysis implementation rate, access to rehabilitation, hospital stay and early prognosis. As the leading cause of disability and the second leading cause of death in developed countries, stroke requires a well-organised, evidence-based healthcare system provided for both acute treatment and rehabilitation. Continuous monitoring of healthcare is crucial to identify weaknesses and areas for improvement.
Keywords
acute ischaemic stroke, thrombolysis, rehabilitation, mortality
About this articleTitle
Differences in acute ischaemic stroke care in Poland: analysis of claims database of National Health Fund in 2017
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
449-455
Published online
2020-09-04
Page views
1213
Article views/downloads
1192
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2020;54(5):449-455.
Keywords
acute ischaemic stroke
thrombolysis
rehabilitation
mortality
Authors
Michał Maluchnik
Danuta Ryglewicz
Halina Sienkiewicz-Jarosz
Adam Kobayashi
Maria Barcikowska-Kotowicz
Barbara Więckowska
Bartosz Karaszewski
Maciej Niewada
References (22)- Collaborators, 2016 SG. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019: p. : 439–458.
- Sarzyńska-Długosz I, Skowrońska M, Członkowska A. Organization of acute stroke services in Poland - Polish Stroke Unit Network development. Neurol Neurochir Pol. 2013; 47(1): 3–7.
- Jauch EC, Saver JL, Adams HP, et al. American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Peripheral Vascular Disease, Council on Clinical Cardiology. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(3): 870–947.
- Ryglewicz D, Polakowska M, Lechowicz W, et al. Stroke mortality rates in Poland did not decline between 1984 and 1992. Stroke. 1997; 28(4): 752–757.
- Niewada M, Sarzyńska-Długosz IM, Skowrońska M, et al. Pharmacotherapy prior to and in acute ischaemic stroke. The use of pharmacotherapy and drug-associated outcomes in real world practice - findings from the Polish Hospital Stroke Registry. Neurol Neurochir Pol. 2013; 47(6): 509–516.
- Niewada M, Skowrońska M, Sarzyńska-Długosz IM, et al. Pharmacotherapy prior to and in acute haemorrhagic stroke. The use of pharmacotherapy and drugs associated outcomes in real-world practice - findings from the Polish Hospital Stroke Registry. Neurol Neurochir Pol. 2013; 47(6): 517–524.
- Niewada M, Skowrońska M, Ryglewicz D, et al. Polish National Stroke Prevention and Treatment Collaborative Group. Acute ischemic stroke care and outcome in centers participating in the Polish National Stroke Prevention and Treatment Registry. Stroke. 2006; 37(7): 1837–1843.
- Niewada M, Jezierska-Ostapczuk A, Skowrońska M, et al. Weekend versus weekday admissions in Polish stroke centres -- could admission day affect prognosis in Polish ischaemic stroke patients? Neurol Neurochir Pol. 2012; 46(1): 15–21.
- Sienkiewicz-Jarosz H, Głuszkiewicz M, Pniewski J, et al. Incidence and case fatality rates of first-ever stroke - comparison of data from two prospective population-based studies conducted in Warsaw. Neurol Neurochir Pol. 2011; 45(3): 207–212.
- Szczuchniak W, Kozera G, Sobolewski P, et al. Pomeranian Stroke Registry collaborators. Length of stay in emergency department and cerebral intravenous thrombolysis in community hospitals. Eur J Emerg Med. 2017; 24(3): 208–216.
- Klimkowicz A, Dziedzic T, Slowik A, et al. Incidence of pre- and poststroke dementia: cracow stroke registry. Dement Geriatr Cogn Disord. 2002; 14(3): 137–140.
- Starostka-Tatar A, Łabuz-Roszak B, Skrzypek M, et al. Characteristics of hospitalizations due to acute stroke in the Silesian Province, Poland, between 2009 and 2015. Neurol Neurochir Pol. 2018; 52(2): 252–262.
- Kozera G, Chwojnicki K, Gójska-Grymajło A, et al. Pomeranian Stroke Register collaborators. Pre-hospital delays and intravenous thrombolysis in urban and rural areas. Acta Neurol Scand. 2012; 126(3): 171–177.
- Chwojnicki K, Ryglewicz D, Wojtyniak B, et al. Acute Ischemic Stroke Hospital Admissions, Treatment, and Outcomes in Poland in 2009-2013. Front Neurol. 2018; 9: 134.
- Pace M, Cayotte E, Agafitei L, et al. Revision of the European Standard Population. Report of Eurostat's task force. Luxembourg: European Commission, Eurostat, Publications Office. ; 2013.
- Gierlotka M, Labuz-Roszak B, Wojtyniak B, et al. Early and One-Year Outcomes of Acute Stroke in the Industrial Region of Poland During the Decade 2006-2015: The Silesian Stroke Registry. Neuroepidemiology. 2018; 50(3-4): 183–194.
- Łabuz-Roszak B, Skrzypek M, Starostka-Tatar A, et al. Epidemiological analysis of hospitalisations due to recurrent stroke in the Silesian Province, Poland, between 2009 and 2015. Neurol Neurochir Pol. 2019; 53(4): 277–290.
- Ryglewicz D, Baranska-Gieruszczak M, Czlonkowska A, et al. A prospective community-based study of stroke in Warsaw, Poland. Stroke. 1994; 25(3): 547–551.
- Schwamm LH, Fonarow GC, Reeves MJ, et al. Get With the Guidelines-Stroke is associated with sustained improvement in care for patients hospitalized with acute stroke or transient ischemic attack. Circulation. 2009; 119(1): 107–115.
- Stevens E, McKevitt C, Emmett E, et al. The Burden of Stroke in Europe, the Challenge for Policy Makers. London: King's College London for the Stroke Alliance for Europe (SAFE), Stroke Alliance for Europe. ; 2017.
- Aguiar de Sousa D, von Martial R, Abilleira S, et al. Access to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries. Eur Stroke J. 2019; 4(1): 13–28.
- Budincevic H, Tiu C, Bereczki D, et al. CEESS Working Group. Management of ischemic stroke in Central and Eastern Europe. Int J Stroke. 2015; 10 Suppl A100: 125–127.
