[Current status and issues of stroke care in the Hokumou Secondary Medical District: the activity of the Okhotsk Stroke Association].

Abstract

To achieve good care for stroke patients in the Hokumou Secondary Medical District, we reaffirmed the current status of the services, discovered the keypoints and issues, and searched for solutions to the current problems. The population, its age composition and the number of beds occupied by stroke patients--stratified in acute, convalescent and maintenance stages-were surveyed. The number of patients suffering from stroke under the jurisdiction of this district was compiled, by using the "regional alliance path for stroke," and the severity and outcome of each case were evaluated by using the mRS (modified Rankin Scale). We held seminars for citizens' on the prevention and management of stroke and the attendees were asked to fill out questionnaires, and were organized: networks for medical care and nursing in the Okhotsk Sea area and people's voices were heard at the network meetings; and at the town meetings held at Kitami, Abashiri and Bihoro, the challenges and problems in each area were discussed. The findings obtained from these activities were compiled for the current study. The rate of release of the patients to their home environment was high in the acute stage but low in the convalescent stage. To substantiate the regional management of stroke patients, it is essential that one be familiar with the availability of the limited medical recourses for and dynamics of patients. And yet, there is a limit to the efforts that the medical profession alone can make for the acute and convalescent stages. It is necessary that the health services assist in solving the problems, with the cooperation of the citizens and the nursing network that is involved in homes and nursing facilities for the care of patients in the maintenance stage.