KYIV. Oct 26 (Interfax-Ukraine) – Ukraine continues to create stroke centers and a network of clinics that provide medical care to patients with stroke, as well as introduces new effective stroke therapy methods.
This was discussed by the participants of the panel discussion on the subject “Strategic Issues of Stroke Control in Ukraine” hosted by the press center of the Interfax-Ukraine News Agency on Tuesday.
According to Deputy Health Minister of Ukraine Oleksiy Yaremenko, due to the COVID-19 pandemic and the war in Ukraine, an increase in the number of strokes can be expected, so the need to create and develop a capable network of medical institutions that can provide care to stroke patients is becoming extremely urgent.
“We have disappointing statistics, the number of strokes in Ukraine is growing. In 2020, we had 124,000 stroke patients, in 2021 – 134,000. In the future, we expect the number to grow, as both COVID-19 and the war affect each of us. The medical system must prepare for such a load,” he said.
At the same time, Yaremenko noted that the goal of Ukraine is, in particular, to ensure the treatment of 90% of patients with stroke in specialized departments or centers.
“Unfortunately, outdated approaches to the treatment of strokes, when patients were sent to the nearest hospitals, which were not sufficiently equipped and did not have the appropriate specialists, have been used in Ukraine for years. As part of the implementation of the Medical Guarantee Program, a network of medical institutions was determined for providing free medical care for stroke patients and appropriate changes were proposed to the routes of patients.The next key step will be the formation of a capable network, we will identify medical institutions that can both technologically and geographically provide the population with access to appropriate free medical care. There will be 450 of them throughout the country, so that each patient has guarantees that there are specialists and medicines,” he said.
“A lot of work is planned, including with emergency assistance, to review and work out the routes of patients in order to send them to capable medical institutions. The National Health Service of Ukraine is reviewing tariffs and contracts with medical institutions to ensure that medical services are free,” Yaremenko said.
In turn, member of the Board of the NGO Ukrainian Association for Stroke Control Yuriy Flomin praised the changes that have occurred over the past five years in the strategy and tactics of treating strokes.
“Before, the situation was completely different, patients were sent to 500-800 different hospitals, not all of which had the opportunity for timely diagnostics and treatment. The frequency of using modern methods of treating stroke, such as trambolysis and thrombomechanical extraction, was extremely low, it was even inconvenient for us to report Ukraine’s performance at international conferences, because they were extremely low, but now the situation is changing,” he said.
At the same time, according to Flomin, currently, modern methods of stroke treatment are available only in certain hospitals, so Ukrainian neurologists welcome the advanced European experience in creating a network of stroke hospitals.
“If the necessary therapy is carried out in a timely manner, it is possible to radically change the course of the disease and put a person on his feet,” he said.
In turn, Head of the NGO Ukrainian Association of Endovascular Neurorentgenosurgery Dmytro Schehlov emphasized that “high technologies and treatment, which seemed inaccessible yesterday, are now becoming available to the general population.”
“Endovascular neurosurgery is rapidly advancing and techniques that put the patient back on their feet are becoming part of the practice of stroke management and supported by the National Health Service of Ukraine,” he said.
At the same time, according to Schehlov’s estimates, there are currently only around ten hospitals in Ukraine where medical care is provided by thromboextraction methods.
“Such assistance is still not widespread enough, there are not enough specialists who can perform such surgeries,” he said.
Schehlov noted that currently Ukraine needs to train around 200 neurologists who could perform thrombectomy, however, there is a high demand for such training.
“I see that there is a lot of work being done and there is a lot of demand among young neurosurgeons and neurologists who want to do this,” he said.
In turn, Head of the neurological department of the town Hospital No. 2 of Bila Tserkva Liudmyla Lipovenko said that this clinic “has become a large hub for receiving patients with stroke from other regions”, accepting residents of around eleven districts of Kyiv region and Bila Tserkva.
“During the year, our department treats around 2,000 acute strokes, more than 354 thrombolytic therapies are performed per year. Our clinic conducts rehabilitation – both early and, from December 1, we plan to start late rehabilitation, we are introducing endovascular treatment methods. These are saved lives and recovery opportunities,” she said.
For her part, Executive Director of the NGO Ukrainian Association for Stroke Control Maryna Huliayeva stressed the importance of stroke prevention and timely rehabilitation.
In addition, according to her, despite the current shortage of medical personnel in Ukraine who practice advanced methods of treatment and rehabilitation, at present “the outflow of personnel abroad has not affected the provision of medical care to stroke patients.”
“The stroke service is operating at full capacity. As of September 2022, we have a report from the National Health Service of Ukraine that 44,000 stroke patients received specialized care in medical institutions that were contracted under the priority stroke treatment package. All medical institutions that are contracted have rehabilitation departments,” she said.
Huliayeva noted that “there are many myths saying that a stroke needs to be treated for months, but this is not true.”
“Now the standards are being updated, without a clinical protocol, no care is provided in any hospital. A legal framework is being created so that the quality of care does not differ from European ones. A very important component is the return of the patient to public life. A lot is being done at the state level for this,” she said.