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Main arrow Archive of previous Issues arrow ╣1 2013 (29) arrow Analysis of medical organizational measures for prevention of strokes and rehabilitation of post-stroke conditions at the present stage
Analysis of medical organizational measures for prevention of strokes and rehabilitation of post-stroke conditions at the present stage Print
Tuesday, 19 March 2013

V.I. Skvortsova1, G.S. Alekseeva2, N.Yu. Trifonova3
1
Ministry of health of the Russian Federation, Moscow
2City clinical hospital #20, Moscow
3I.M. Sechenov First Moscow State Medical University

Summary. According to international medical social studies in the majority of countries stroke takes one of the leading places in the population mortality structure. WHO deefines strike as a ôrapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than of vascular originö. In Russia stroke is at the same time a major medical and social problem consistently taking the second place in mortality structure and being second only to cardio-vascular pathology. Annual rates of mortality from strokes in Russia exceed 125 per 100,000 of population taking one of the leading places in the world.

Stroke is the leading cause of population disability. According to data of National stroke association of the Russian Fedearation more than 30.0% of stroke patients need permanent care, 20.0% canĺt walk independently, only about 21.0% are returning to their professional activity. Stroke demands not only higher engagement from patientĺs family members but becomes a heavy socio-economic burden for the society.

During the last years, neurologists, cardiologists, cerebral surgeons and other medical professionals enhance their integrated efforts for improvement of the system of primary and secondary prevention of strokes, for increasing of quality of medical social rehabilitation for stroke patients. High-tech methods of diagnostics and treatment of strokes are actively introduced into practice. Nonetheless, levels of disability and mortality from strokes in our country remain rather high in comparison with the same in developed countries.

As things currently stand, any changes could be achieved only by the development of an adequate treatment and prevention care and introduction of a new approaches to a staged medical care for stroke patients. Such approaches should be based upon two main directions: decreasing of stroke morbidity by means of effective prevention methods and by reduction of lethality in stroke cases due to improvement of the system of high-quality medical care.

Keywords. Stroke; post-stroke patients; medical organizational measures; efficiency; stroke prevention.

References

  1. Vilenskiy BT. Proceedings of the 5-th World Stroke Congress. Vancouver, Canada, June 23-25 2004. Neurological journal 2005;(4):55-62 (in Russian).
  2. Gusev EI. Stroke problem in Russia. S.S. Korsakov Journal of neurology and psychiatry. Stroke (Supplement ) 2003; 9:S3-5 (in Russian).
  3. Gusev EI, Skvortsova VI, Stakhovskaya LV, Ayriyan NYu. Epidemiology of stroke in Russia. Hemorrhagic stroke. Master-class. Moscow 2004. P. 4-8 (in Russian).
  4. Evzel'man M.A. Providing health care to patients with ischemic stroke: Methodic Guides. Orel; 2005. 145 p. (in Russian).
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  6. Kuznetsova IV, Dymochka MA. Role of risk factors of primary disability caused by cerebral stroke for solving prevention problems. In: Problems of Regional Healthcare. ╠. 2004. P. 172-175 (in Russian).
  7. Kubanova AA, Martynov AA, Pirogova EV. Application of information and telecommunication technologies in specialized facilities. In: Proceedings of XI All-Russian Congress of dermatovenerologists and cosmetologists. Yekaterinburg; 2010. P. 25-26 (in Russian).
  8. Rodionova Yu.M. Organization of healthcare to cerebral stroke patients in a rehabilitation period in outpatient conditions. Cand.Sci.Med [thesis]. Moscow; 2012. 25 p. (in Russian).
  9. Skvirskaya GP, Il'chenko IN, Syrtsova LE, Abrosimova YuE. Structural and functional models of prevention activity for outpatient clinics and specialists: Methodic guides. Moscow; 2009. 69 p. (in Russian).
  10. Broderick JP, William M. Feinberg Lecture: Stroke therapy in the year 2025. Burden, breakthroughs and barriers to progress. Stroke 2004; 35(1):205-211.
  11. Caplan LR. Stroke is best managed by neurologists. Stroke 2003; 34(11): 27-63.
  12. Heuschmann PU, Kolominsky-Rabas PL, Visswiltz B, et al. Factors influencing duration of hospitalization after stroke in Germany. Dtsch Med Wochenshcr 2004;129:299-304.

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