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  • Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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24 September 2015

A Chart Review of Management of Ischemic Stroke Patients in Germany

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1
H. Lundbeck A/S, Issy Les Moulineaux, France
2
laboratoire ERIC, Université Lumiére Lyon 2, Bron, France
3
Creativ-Ceutical, Paris, France
4
University of Illinois at Chicago, Chicago, IL, USA

Abstract

Background: Ischemic stroke (IS) poses physical, emotional, and economic burdens on both patients and the healthcare system in Germany. However, the management of IS is not well described, especially after hospital discharge. In this study, we aim to describe the management of IS at onset, admission, and during follow-up. Methods: German general practitioners (GPs) (n = 40) extracted data on patient characteristics, hospitalizations, discharge, and ambulatory care from both GPs patient databases and hospital letters. Descriptive analyses were conducted. Results: The sample included 185 patients with a mean age of 70 years [standard deviation (SD) = 11.7]. Most patients (63%) contacted the Emergency Medical Services, while 36% contacted their GPs. The majority of patients were hospitalized within 1 h from onset, and the length of stay was on average 14 days. Half of the patients (50%) were admitted to the stroke unit, and 16% of patients received thrombolysis treatment with 2 h (SD = 2.6) of time to treatment. Of the admitted patients, 32% were discharged to their homes, while the remaining patients were discharged to nursing homes (16.2%) and rehabilitation centers (47.6%). During the 12 months follow-up, 22% of patients were re-hospitalized and patients visited their GP (11.7 times), psychologist or psychiatrist (9.5 times), and neurologist (2.2 times). Death rate after stroke event was 13%. Conclusion: The rate of patients who received thrombolysis is lower than the optimal rate in Germany. More research is needed to determine the factors that could predict the utilization of thrombolysis treatment.

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