Post-stroke care in Poland far from bad, with room for improvement

Poland records 70,000 strokes annually and state-funded rehabilitation is by no means the worst in Europe, but it could still improve, the deputy head of the country’s post-stroke care foundation told Euractiv Poland.

Every year, about 1.1 million people in Europe suffer a stroke, including about 60-70,000 in Poland, of whom 30,000 patients do not survive, while those who do survive strokes are often faced with a high risk of permanent disability.

Stroke can cause a variety of disorders, such as speaking, swallowing, writing, and memory problems.

Therefore, it is essential to provide post-stroke patients with the widest possible range of rehabilitation treatments, which may enable them to at least partially recover.

Post-stroke care starts in the hospital and involves, among other therapies, massage, kinesiotherapy, and compression therapy.

After discharge from the hospital, the patient should continue active recovery. In Poland, post-hospital stroke therapy is state-funded.

Post-stroke patients in Poland have access to 16 weeks of rehabilitation, according to Adam Siger, vice president of the Polish Brain Stroke Foundation (Fundacja Udaru Mózgu).

“Patients are entitled to up to 80 treatments for one year after a stroke, with the option of extending it if the injured person’s state of health requires it,” Siger told Euractiv Poland.

This involves home rehabilitation, but also day rehabilitation stay with five to six hours a day in a clinic.

The unreachable rehabilitation

Still, only 30% of post-stroke patients use state-reimbursed therapy, according to Siger.

“This is because the demand exceeds the supply. Also, not all patients qualify to receive rehabilitation in clinics due to their serious post-stroke condition,” he said.

Many units lack specialised equipment necessary for treating some post-stroke complications.

“Patients may require enteral feeding or suctioning, for example. Aphasia also hampers rehabilitation. Another problem is the insufficient number of places at rehabilitation wards.”

Those whose health condition requires additional resources are either forced to use the services of private health centres or end up in care facilities.

“In terms of the quality of post-stroke rehabilitation, Poland is in the middle of the European ranking,” Siger said. 

“We cannot compare with Germany, Switzerland or Belgium, but our health care is at the same or maybe even higher level as in Italy, France or Portugal.”

Room for improvement

Asked what could be improved in post-stroke treatment in Poland, Siger mentioned communication.

“After a stroke, the patient stays in the hospital for seven to 10 days. Then he or she is discharged and does not really know what to do next, unlike cardiac patients. There is no coordinated care for stroke patients,” he said.

The Brain Stroke Foundation runs the only helpline in Poland for stroke patients and their families.

“People often call us with questions about different aspects of life after a stroke. Stroke patients in Poland lack information and guidance,” Siger said.

The number of strokes is rising in Poland, including among children.

Risk factors include stress, hypertension, diabetes, smoking, drug use, obesity and alcohol abuse. The chance of having a stroke increases with age and men are more likely to suffer from it.

Strokes are the main cause of disabilities among healthy Poles, with 30% of cases ending with disability. Still, they remain largely neglected by decision-makers.

“As the Brain Stroke Foundation, we lack appropriate tools to put pressure on the authorities. Our patients are mainly sick, elderly people of post-working age,” Siger stressed.

“However, we intend to present to lawmakers our proposal for the Polish version of the Stroke Action Plan for Europe, which would contain recommendations on what to do so that patients have the widest possible access to various types of post-stroke services. No organisation has promoted such a strategy until now.”

[Edited by Giedrė Peseckytė/Zoran Radosavljevic]

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