Асоциация за инсулт и афазия: 2025г - проблеми и предизвикателства в борбата с инсулта

The Association for Stroke and Aphasia (ASA) continues to be committed to protecting the rights of stroke patients in Bulgaria. Despite the efforts of the organization over the past 4 years, there are still significant problems and unresolved issues in the sector, and the past year may turn out to be a record year with over 50,000 stroke accidents.

In 2021, at the initiative of the ASA, the Ministry of Health adopted the European Stroke Plan with a special declaration. Despite this important progress, a National Stroke Plan has not yet been created and approved by the Ministry of Health. Although the ASA is the only patient organization protecting the rights of stroke victims in the country, it has not been invited for an opinion or participation in a working group during the period of the caretaker government, as well as has not been informed about the planned national interventions in the sector.

The creation of specialized stroke units, financed by the recovery plan, is one of the most important actions in recent years. The second key action is the launch of the helicopter transfer*. Despite the lack of commitment on the part of the Ministry, the ASA closely monitors the processes in the country. The association expresses concern about the lack of transparency and the danger of inefficient use of significant public funds.

Successful management of stroke requires a coherent system of interconnected stroke services, stretching from disease prevention, through acute phase treatment, rehabilitation, supportive therapy, training and retraining, and social services shaping the needs of the so-called "Stroke Prevention System". Life after a stroke. The organization of stroke services is a complex systemic issue that requires a holistic approach. As early as 2008, a number of publications in specialized medical journals, for example, reported the successful model of building a large network of small stroke units, supported by geographically located few but highly specialized stroke centers. An example of a successful model is the Swedish one, which involves the creation of a network of neurological centers. In Sweden, about 30,000 people suffer from stroke every year, 20,000 of them for the first time. The average age of victims is 75 years, with 20% of cases occurring in people under 65 years old. The Swedish model provides intensive rehabilitation programs for people with neurological deficits who were previously independent and without severe cognitive deficits. These programs are offered in acute patient hospitals or specialized neurological rehabilitation centers.

The main advantages of the Swedish model include:

Intensive rehabilitation programs

Integrated approach

Equal access to treatment

Focus on rehabilitation

Of course, a good model cannot be easily and quickly applied in Bulgarian practice. Possible challenges in implementing it include a shortage of healthcare professionals, cumbersome administrative procedures, lack of a strategic framework, infrastructure and financial resources, and cultural differences**.

The ASA expresses serious concerns that work is not being done to build the basic infrastructure, which should include highly specialized stroke centers. The issues of ensuring equal access to modern treatment, providing diagnostics and transport to treatment within the therapeutic window - up to 3 hours from the accident - remain unresolved.

Next week, Sofia will host the annual meeting of the National Coordinators for the implementation of the European Stroke Plan. In this regard, the Association will inform the public about the upcoming update of this most significant strategic document at European level.

ASA continues its work to improve the conditions and care for stroke patients in Bulgaria, insisting on transparency and efficiency in healthcare. Your support is essential to the success of these efforts.

 

 

 

* Helicopter transfer is a key element in providing fast and effective medical care for stroke patients. In recent years, Bulgaria has seen significant progress in this area. For example, the medical helicopter transported a stroke patient from Haskovo to Sofia, and the flight was organized by the Center for Emergency Medical Care by Air (CSMPV) and was implemented by a team of the Coordination Center. Another case involves the transportation of a 29-year-old woman in a coma after a stroke from Blagoevgrad to the District Hospital in Sofia. Since the launch of the air ambulance system in June, 43 missions have been carried out, most often from the so-called "hospital to hospital", when a patient has to be transported from one hospital to another.

** In Sweden, early prevention of a number of diseases has been worked on for years. The health literacy and culture of the population are significantly superior to those of the general public in our country.