Exact(1)
The centralisation of stroke services in London, which involved the controversial closure of five hospital units, saves nearly 100 lives a year, according to research.
Similar(59)
It included (1) centralisation of acute stroke treatment at specialised hospitals, (2) a reduced length of hospital stay, and (3) a shift from inpatient rehabilitation programmes to community-based rehabilitation programmes.
Objective To investigate whether centralisation of acute stroke services in two metropolitan areas of England was associated with changes in mortality and length of hospital stay.
Since the centralisation of acute stroke services in two metropolitan areas, risk adjusted mortality and length of hospital stay fell in Greater Manchester, London, and the rest of the country.
We evaluated whether centralisation of acute stroke services in Greater Manchester and London had an impact on mortality and length of hospital stay using regression analysis of difference-in-differences between regions 25 to compare the changes over time in these areas with the change over time in the rest of England.
As a result of the centralisation of services five acute stroke units in London were closed down.
The researchers acknowledge the potential that the greater reductions in stroke mortality in London may have been influenced by variations in stroke severity, travel distances and public awareness of stroke but their findings still add to the rationale for further centralisation in Greater Manchester".
London's reform of stroke services is often held up as proof of the importance of the centralisation of services.
England's national stroke director Prof Tony Rudd said the research showed centralisation of care should now be spread to all urban areas.
This centralisation of electrical power, means that the economic and political power is centralised too.
We do not need a centralisation of all economic policies.
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