London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 477 361 Management and economics COMPREHENSIVE STROKE CARE PATHWAY AND NETWORK IN TYROL S. Kiechl1, A. Tuer2, T. Geley3, H. Kreuzer4, H. Schoech5, N. Jaeger6, H. Rinner7, J. Willeit8 Department of Neurology, Medical University Innsbruck, Innsbruck, AUSTRIA1, Department of Neurology, Medical University Innsbruck, Innsbruck, AUSTRIA2, Tyrolean Regional Health Fund, Innsbruck, AUSTRIA3, Tyrolean Regional Health Fund, Landeck, AUSTRIA4, Tyrolean Re-gional Health Fund, Innsbruck, AUSTRIA5, Tyrolean Regional Health Fund, Innsbruck, AUSTRIA6, Tyrolean Regional Health Fund, Innsbruck, AUSTRIA7, Department of Neurology, Medical Univer-sity Innsbruck, Innsbruck, AUSTRIA8 Background and aims: Continuous advances in acute stroke therapy and management do not imme-diately translate into clinical routine and there is still a difference in the quality of stroke care be-tween leading stroke units and standard hospitals to be addressed by network- or telemedicine-based programs. Methods: In Tyrol, a federal state of Austria with 710.000 inhabitants, a comprehensive stroke net-work and patient pathway was assembled which spans the whole country, includes all health pro-fessionals involved in stroke care as well as the patients themselves and relatives, and considers pre-hospital, hospital, in-patient and out-patient rehabilitation phases. The programme was imple-mented in 2009 and consists of a number of individual components (e.g. information campaign, tri-age algorithms for emergency doctors, standardized protocols for diagnosis and therapy, stroke man-ual, interface management, dysphagia screening and documentation of key characteristics). Results: Success of the stroke pathway is exemplified as follows: knowledge about stroke symptoms in the general community substantially improved within one year after programme implementation as ascertained by telephone survey (two samples of n=500). The country-wide proportion of stroke patients receiving intravenous thrombolysis increased from 5.6% (2008) to 13.6% (2010) with an ongoing upwards-trajectory. In one district of Tyrol without respective facilities prior to the pro-gramme, a standardized and quality-controlled out-patient rehabilitation services was established capable of managing the majority of stroke patients in the region. Conclusions: Implementation of the programme sustainably improved stroke care in Tyrol at low costs and with a realistic perspective of future reductions in health and nursing expenditures. 362 Management and economics Management of acute ischaemic stroke over a 12-month period in France, Germany and West Scotland: implications for the introduction of new treatments P. Verpillat1, C. Guilhaume-Goulant2, J. Dorey3, S. Aballéa4, M. Toumi5 H. Lundbeck A/S, Issy-les-Moulineaux, FRANCE1, University Claude Bernard Lyon 1, Villeur-banne, FRANCE2, Creativ-Ceutical, Paris, FRANCE3, Creativ-Ceutical, Paris, FRANCE4, Universi-ty Claude Bernard Lyon 1, Villeurbanne, FRANCE5 BACKGROUND: Limited information is available on the long-term management and related eco-nomic burden for patients with acute ischaemic stroke (AIS). Such data will be required to assess the economic impact of new therapies for AIS. In this study we described patient management and healthcare resources used during the first year after AIS in France (Fr), Germany (Ge) and West Scotland (WS). METHODS: An observational study was performed via general practitioners (GP) recruited through professional networks representative of GP populations in Fr, Ge and WS. Each GP was asked to select patients in chronologic order based on the stroke onset date (inclusion date) and to complete a form with data from the medical records for patients with AIS within the period 2005-2006 (Fr) or 2007-2008 (Ge, WS). Descriptive analyses were performed. RESULTS: The sample size was 196, 185 and 101 in Fr, Ge and WS respectively. Most patients were males (except in WS) and the average age was above 65 years. 85 to 90% of the patients did not have stroke history. The mean length of hospital stay was longer in Fr than in Ge and WS (21 vs. 14 and 12 days). In Ge, 48% of the patients went to a rehabilitation centre after discharge compared to 25% in Fr and 4% in WS. Re-hospitalisation rates were 16, 22 and 28% in Fr, Ge and WS. Use of outpatient care resources, consumption of psychological support, physiotherapy, occupational or speech therapy was also highly variable: e.g., 44.6% of the patients in Fr benefit from nursing care compared to 26.5% in Ge and 10.9% in WS. CONCLUSION: Post-stroke management of AIS patients, and consequently related economic bur-den, varies significantly from country to country. This may be partly explained by differences in acute AIS management. Availability of more efficient treatment options for this acute phase (e.g., new thrombolytic drugs) could then ease the disease burden and make the long-term post-stroke management more universal among different countries.
Karger_ESC London_2013
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