シンポジウム1―5　脳血管障害：基礎と臨床の最前線　脳卒中連携医療：新しい脳卒中医療・介護システムの構築

抄録

Stroke patients receive acute care and a variable period of rehabilitation in community hospitals. Some patients also receive long-term care in nursing homes. Quality assessment of each hospital and nursing home does not necessarily reflect quality of total stroke care providing in the community. Clinical indicators representing total stroke care are needed for the continuous improvement of stroke care. In several countries, measurement of quality of stroke care had recently been started. Since 1998, National Sentinel Stroke Audit had been performed every two years using simple 12 clinical indicators in England. In 2000, a nation-wide audit system named "Nationale Indikator Projekt Apopleksi" was developed in Denmark. In 2006, the quality indicator board of the German Stroke Registers Group published indicators for measuring quality of acute stroke care. In 2007, the first issue of the National Sentinel Stoke Audit was published in Australia.
Clinical indicators must be meaningful, valid, and evidence-based. Inter-rater reliability, internal consistency, and test-retest reliability should be tested to serve as a useful marker of healthcare quality in the community. It is urgently need to develop adequate indicators for measuring quality of stroke care in Japan.