Aim: To determine changes in the organisation of acute stroke management in New Zealand between 2001 and 2007.
Method: A questionnaire was sent to 58 New Zealand hospitals; it included questions about access to organised stroke care, the presence of designated areas for stroke patient management, guidelines for stroke management, and audit.
Results: Responses were received from all hospitals surveyed, with 46 admitting stroke patients either acutely or for stroke rehabilitation. Sixteen District Health Boards (DHBs) covering 88% of the population have a physician who provides overall leadership for stroke services. Seven of 46 hospitals, covering 48% of the population, had areas designated for acute management of stroke patients. Rehabilitation for patients older than 65 years was carried out in designated areas for patients with stroke in seven hospitals, covering 49% of the population. Only 13 hospitals (serving 60% of the population) had audited local inpatient stroke care at the patient level and 10 (45% of the population) at the service level.
Conclusion: While there have been improvements in the development of an organised approach to acute inpatient acute stroke care in New Zealand there remain major variations between different centres. The training of general physicians, geriatricians, and neurologists in stroke medicine must be seen as a priority.