THOUSANDS of regional and rural patients may be missing out on life-saving stroke treatments around Australia.
A Stroke Foundation report has found that rural and regional Australians are at greater risk of death or disability from stroke than people in major cities because they are not getting the right treatment at the right time.
"Surviving and living well after stroke should not be determined by your postcode," said Stroke Foundation Clinical Council chair Professor Bruce Campbell.
The leading stroke expert says it is a "travesty that there is such a wide gap in 2019" amid calls for improved access to emergency stroke treatment through telehealth and clinical pathways.
His comments follow the release of the Stroke Foundation's 2019 National Audit Acute Stroke Services Report. It found that 79 per cent of metropolitan patients access a stroke unit compared to 55 per cent of inner regional patients and 35 per cent outer regional patients.
Prof Campbell said there is "significant opportunity for improvements which will save lives and benefit all Australians."
He said while there have been advancements in emergency stroke treatment, meaning stroke is more treatable, the report showed regional health services and their patients were being left behind.
"While major city hospitals are innovating, enabling their patients to benefit from the latest break-throughs, regional patients have limited access to well established standard stroke treatments."
Prof Campbell said there must be clear links and referral pathways to ensure the major city hospitals support regional hospitals in treating stroke.
"If we consider emergency stroke treatment of the most common type of stroke - caused by blood clot, it is estimated 20-25 per cent of these patients could benefit from some form of clot dissolving [thrombolysis] or clot retrieval [endovascular thrombectomy] therapy, which means more than double the current numbers are likely to be eligible,'' he said.
Stroke Foundation Chief Executive Officer Sharon McGowan said Australia has one of the most advanced trauma systems in the world and we need to apply the same critical care thinking to acute treatment. She said every stroke is a medical emergency and needs to be prioritised to ensure rural and regional Australians are not denied access to best practice care.
"Times are tough for people in the bush. They are not only dealing with drought and bushfires, but inequality in the health system," Ms McGowan said.
"They must be given the best chance to survive and be well supported throughout rehabilitation and the transition home to live well after stroke.
"The Australian Government has paved the way with the development of the National Strategic Action Plan for Heart and Stroke. Improved access to emergency stroke treatment through telehealth and clinical pathways are highlighted as key actions in the Plan. Governments must now work together to enable all Australians to benefit from the advances that a national telestroke network can realise."
The audit also highlighted examples in Victoria and South Australia, where improvements to stroke treatment and care have been made. Using telehealth technology regional and rural centres can link to expert clinicians based in comprehensive stroke centres in the major cities, providing them assistance with early diagnosis and referral pathways.
Key findings:
- 35 per cent of patients with stroke reached hospital within the critical 4.5 hour window for thrombolysis treatment.
- Delivery of thrombolysis within targeted 60 minutes of hospital arrival lags internationally; 32 per cent in Australia compared to 59 per cent in the US and 62 per cent in the UK.
- 79 per cent of metropolitan patients access a stroke unit compared to 55 per cent of inner regional patients, 35 per cent outer regional patients.
In 2019, 120 hospitals participated in the Acute Services Audit, accounting for more than 35,000 patients.
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