Stroke numbers are on track to increase by 40 per cent over the next decade unless urgent action is taken to reduce the looming healthcare burden, a new study has found. The annual cost of strokes in New Zealand is estimated at $700 million, a figure that could spiral if the projected increase holds true.

The University of Otago, Wellington associate professor Anna Ranta led the research on projected stroke volumes published in the June edition of the New Zealand Medical Journal.

Despite a downward trend in stroke rates and mortality, the study found if further reductions do not occur the number of strokes is anticipated to increase by 40 per cent from 7231 in 2015-16 to 10,112 in 2028.

Ranta said this was because of a growing and ageing population. "It's a huge increase," she said. "While we're just managing at the moment, if we don't change anything we will not manage. That's basically the problem and it'll have implications for what services people can access.

Associated with the projected increase in stroke numbers was a need for more staff and hospital beds. If the 40 per cent figure holds true, the study estimated stroke patients would need 191 acute beds around the country.

Ranta described her research as "a wake-up call" and said there were three main things that needed to happen in order to minimise and deal with an increased number of strokes in the future."If we do it in 10 years, it'll be too late. We need to do it now."

Chief among them was increasing stroke prevention initiatives.

It had been suggested, the study said, that up to 90 per cent of the world's stroke burden was attributable to modifiable risk factors and that controlling metabolic and behavioural circumstances could avert more than three-quarters of strokes.

The big risk factors in New Zealand were high blood pressure, high body mass index, a diet low in fruit and vegetables and smoking. "National policy changes and public awareness campaigns, as well as new ideas as how to best address these issues, are vitally needed," the study said.

Ranta said increased awareness around recognising the symptoms was important so people were able to be treated as quickly as possible.

There also had to be improved hospital planning, so that stroke services were adequately resourced and there was equitable care around the country, she said. "Improving access to acute intervention and rehabilitation services is essential to ensure mortality and disability continue to decline and minimise the societal and individual impacts of New Zealand's increasing stroke burden," the study argued.

Ranta acknowledged her research was limited by the quality of data available – it relied largely on Ministry of Health hospital discharge figures. Better data was needed to improve the accuracy of the projections, she said.

The Auckland Regional Community Stroke studies were cited in Ranta's research as the most up-to-date, high-quality data. They showed stroke incidence had decreased by 23 per cent and mortality by 62 per cent from 1981 to 2012.

However, M?ori and Pacific groups had a slower rate of decline and continued to experience strokes at a significantly younger age than P?keh?, with respective mean ages of 60, 62 and 75-years-old.

Ranta said it was imperative the health sector planned ahead and implemented strategies to reduce the stroke burden, but "it's not just the health system that can fix this – people can fix this."

 

BY THE NUMBERS

The Canterbury District Health Board, according to Ranta's research, treated 874 stroke patients in 2015. Adjusting for age and locality, this was projected to increase 41 per cent to 1235 in 2028.

Waitemata, the other big district health board, treated a reported 872 stroke patients in 2015. With the adjustments, this was projected to increase 45 per cent to 1268 in 2028.

 

Source: Stuff


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