Letter to the editor: Analysis of stroke patient migration for mechanical thrombectomy and changes in neurointerventional center size in Germany

AIM AND METHODS: To analyse nationwide changes in neurointerventional center size of all German hospitals performing mechanical thrombectomy (MT) in stroke patients from 2016 to 2019. Furthermore, we assessed cross-district patient migration for MT for the first time using hospitals' structured...

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Main Authors: Weber, Ralph (Author) , Bartig, Dirk (Author) , Krogias, Christos (Author) , Richter, Daniel (Author) , Hacke, Werner (Author) , Eyding, Jens (Author)
Format: Article (Journal) Editorial
Language:English
Published: 07 June 2021
In: Neurological research and practice
Year: 2021, Volume: 3, Issue: 1, Pages: 1-4
ISSN:2524-3489
DOI:10.1186/s42466-021-00131-2
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1186/s42466-021-00131-2
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Author Notes:Ralph Weber, Dirk Bartig, Christos Krogias, Daniel Richter, Werner Hacke and Jens Eyding

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520 |a AIM AND METHODS: To analyse nationwide changes in neurointerventional center size of all German hospitals performing mechanical thrombectomy (MT) in stroke patients from 2016 to 2019. Furthermore, we assessed cross-district patient migration for MT for the first time using hospitals' structured quality reports and German Diagnosis-Related Groups data in 2019. FINDINGS: Number of hospitals performing more than 100 MT procedures/year doubled in Germany from 2016 (n = 36) to 2019 (n = 71), and these neurointerventional centers performed 71% of all MT procedures in 2019. The overall increase in MT procedures was largely driven by these high-volume neurointerventional centers with ability to perform MT 24/7 (121% increase as compared with 8% increase in hospitals performing less than 100 MT procedures/year). The highest cross-district patient mobility/transfer of stroke patients for MT was observed in districts adjacent to these high-volume neurointerventional centers with existing neurovascular networks. CONCLUSION: The substantial increase in MT procedures observed in Germany between 2016 and 2019 was almost exclusively delivered by high-volume stroke centers performing more than 100 MT procedures per year in established neurovascular networks. As there is still a reasonable number of districts with low MT rates, further structural improvement including implementation of new or expansion of existing neurovascular networks and regional tailored MT triage concepts is needed. 
650 4 |a Health care structure 
650 4 |a Neurointerventional center size 
650 4 |a Patient migration 
650 4 |a Stroke 
650 4 |a Thrombectomy 
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