National Assessment 2011 – Stroke Care – County Council Assessment – Summary

This is the summary of National Assessment 2011 – Stroke Care – County Council Assessment. The report suggests a number of areas of improvement within stroke care.


The percentage of stroke patients suffering from functional impairments have only decreased by a few per cent in the last ten years, and the mortality rate has only marginally decreased during this period. These are some of the findings in this report, a part of the 2011 Swedish National Assessment of Stroke Care. The percentage of patients suffering from a second stroke or other cardiovascular disease has not significantly decreased either, despite access to improved secondary treatment.

Based on the results, the Swedish National Board of Health and Welfare has identified a number of areas of improvement within stroke care:

  • Reduce waiting times for stroke care.
  • Increase the proportion of patients who receive care at a designated stroke unit.
  • Improve secondary prevention.
  • Increase the number of surgical interventions on patients with carotid stenosis (narrowing of the carotid artery).
  • By investing in further improvement of these areas, and through better adherence to the national guidelines, the figures for mortality and functional impairment, and those for relapse following a stroke, should improve.

    This report focuses the county council's efforts for stroke patients. A report on the municipalities’ efforts will follow as well as an analytical report from an overall systems perspective.

Recommendations for health and medical care

Time is an important factor for stroke treatment options. In the current situation, several elements of stroke care are characterized by long waiting periods. Delays can be reduced through the improvement of processes from the health and medical care services.

The manner in which stroke care is organized is important for the quality of care and the results. In recent years, a higher percentage of people have been treated in designated stroke units, but results from certain parts of the country show room for further improvement.

Secondary prevention with medication following a stroke is an important factor in reducing the risk of relapse or of suffering from other cardiovascular diseases. At present, there are marked differences between county councils with regard to the percentage of stroke patients who receive these treatments.

Arranging carotid surgery soon after symptoms in the form of transient ischemic attack (TIA) or mild stroke is important for the prevention of a more severe stroke. At present, it is likely that too few operations are taking place in the country, and waiting periods for surgery vary significantly from one county council to another.

Continued monitoring and assessment

The Swedish National Board of Health and Welfare has identified different elements of stroke care organization, expertise, resources and practices with the help of a survey. This report presents a selection of the responses, where the remainder of the material from the survey will be presented in the following reports.

The Swedish National Board of Health and Welfare intends to reassess stroke care based on the results from this report within a few years. The board will primarily focus on the identified areas of improvement, but other indicators will also be monitored. The aim is that the health and medical care services will use the National Assessment as a starting point in efforts to further improve stroke care.


Read the full Summary


Björn Nilsson 
+46 (0)75-247 30 00