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J Neurol Neurosurg Psychiatry 2004;75:1660-1661 doi:10.1136/jnnp.2004.048157
  • Stroke
  • Editorial commentary

Variations in care and outcome in the first year after stroke: a Western and Central European perspective

  1. H Markus
  1. St George’s Hospital Medical School, London, UK
  1. Correspondence to:
 H S Markus
 St George’s Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK; h.markussghms.ac.uk

    Large differences in outcome and resource utilisation

    Stroke is a major health burden throughout Europe. Despite a reducing incidence in Western Europe,1 the rise in the elderly population and increasing incidence rates in Eastern Europe will result in it becoming a mounting population burden. It consumes a large amount of healthcare resources; in the UK about 5% of the National Health Services’ budget is spent on stroke care. Therefore optimal models for delivery of stroke care, which result in good outcome at reasonable cost, are of great importance. Although robust data has shown that care in a stroke unit (with most trials looking at rehabilitation units) is associated with improved outcome,2 we have limited understanding of which components of this organised care are responsible for this benefit. Comparing practice and outcome across different European countries may give clues that can help us to develop new hypotheses and interventions, which should then be ideally tested in controlled studies.

    In this issue (pp 1702–6) the BIOMED European Study of Stroke Care Group present data from 11 centres in several Central and West European countries.3 The group have …

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