What do rural hospitals do for stroke care in developing and developed countries?
In the UK,I've seen a huge change in stroke care over the time that I've been a doctor.
From the days when care meant time on a ward(usually medical or geriatric) until the injury was complete,and the patient was discharged with often life changing problems,to our current rapid and highly focussed care,with physiotherapy,OT,speech therapy plus surgical and radiological intervention.
The biggest changes now in a "developed" setting,is the trend from each hospital working in isolation,with varying results,to a hub and spoke model,with the hub being able to offer invasive treatments such as thrombectomy or stenting.
The spoke hospitals are expected to offer at a minimum,thrombolysis and immediate care,and to then trnasfer for more intensive treatments if indicated.
The UK doesn't have the large distances between hospitals that other countries may see,but still does have a number of isolated rural hospitals,and delays in diagnosis,transfer,and treatment can still occur.
This remains a sizeable problem.
In Egypt being a developing country we still face some troubles in acute stroke care especially in rural areas .. most hospitals still do not offer thrombolysis .. yet in urban areas there are hospitals that offer both thrombolysis as well as thrombectomy yet still few in numbers .. but we are doing our best to develop a comprehensive stroke care services .. in my hospital which is a university hospital we have two stroke units and we are planning for international accreditation soon .. we began to be more active along the last 2 years in documentation and are doing good on the SITS international database .. we got the second best award from the ESO - Angel initiative along the entire middle east .. and on next December 2018 we are having our 1st national stroke conference with plenty of international speakers who are pioneers in stroke field .. hoping that we augment stroke care more along our urban communities and transfer knowledge to our rural areas
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