Stroke care in Germany: evidence gaps and priorities for health services research and quality assurance.
21 affiliations
- 1Institute for Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany. [email protected].
- 2Institute for medical Data Science, University Hospital Würzburg, Würzburg, Germany. [email protected].
- 3DRG Market, Osnabrück, Germany.
- 4German Stroke Society, Berlin, Germany.
- 5Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
- 6Praxis für Nervenheilkunde, Offenbach, Germany.
- 7Rhön Klinikum, Campus Bad Neustadt, Bad Neustadt an der Saale, Germany.
- 8Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
- 9Department of Neurology, University Hospital Erlangen, Erlangen, Germany.
- 10Institute for Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.
- 11Department of Neurology, University Hospital Würzburg, Würzburg, Germany.
- 12University Hospital Tübingen, Tübingen, Germany.
- 13Klinikum Fulda, University Medicine Marburg - Campus Fulda, Fulda, Germany.
- 14Neurologische Klinik, SRH Gesundheitszentrum, Bad Wimpfen, Germany.
- 15Neurologische Klinik, Klinikum der Stadt Ludwigshafen, Ludwigshafen am Rhein, Germany.
- 16Department of Neurosurgery, University Hospital Gießen, Gießen, Germany.
- 17BDH-Klinik Braunfels, Braunfels, Germany.
- 18Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
- 19Stiftung Deutsche Schlaganfall-Hilfe, Eschborn, Germany.
- 20Landesarbeitsgemeinschaft Qualitätssicherung Hessen, Eschborn, Germany.
- 21Institute for medical Data Science, University Hospital Würzburg, Würzburg, Germany.
Abstract
Stroke remains one of the leading causes of morbidity and mortality in Germany and worldwide. Within this position paper by the Commission Health Services Research and Quality Assurance of the German Stroke Society, we summarize current data on stroke epidemiology, healthcare delivery, and quality assurance of stroke in Germany, identify evidence and knowledge gaps across the stroke care pathway, and derive priorities for future health services research and quality assurance. Based on registry and routine administrative data, approximately 253,000 incident and recurrent strokes were estimated to occur in Germany in 2023. Although age-standardized stroke mortality rates had declined substantially since the 1980s, this trend has reached a plateau since 2018. Acute care is predominantly administered in certified stroke units, characterized by high process and outcome quality. However, areas for improvement remain in post-acute care and in structured outpatient aftercare, particularly regarding appropriate care for patients with persistent functional impairments and unmet needs. Future research priorities include for example the utilization of real-world data to document long-term outcomes, the expansion of quality assurance to specific entities such as subarachnoid hemorrhage, and the evaluation of telemedical frameworks in pre-hospital settings. Systematic implementation of Patient-Reported Outcome Measures (PROMs) in research and clinical practice could facilitate the identification of unmet needs and the development of patient-centered care models. In light of recent legislative advancements (e.g., the Health Data Use Act, European Health Data Space) and technological innovations (e.g., AI-driven applications), new opportunities are emerging to bolster health services research and further optimize the management of stroke patients.
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BibTeX
@article{wiegand2026stroke,
title = {{Stroke care in Germany: evidence gaps and priorities for health services research and quality assurance.}},
author = {Flora Noelle Wiegand and Dirk Bartig and Jürgen Faiss and Christoph Gumbinger and Stephen Kaendler and Tobias Knieß and Peter Kolominsky-Rabas and Felipe A Montellano and Anne Lieb and Tobias Neumann-Haefelin and Christopher Jan Schwarzbach and Hassan Soda and Marco Stein and Inga Sünkeler and Götz Thomalla and Markus Wagner and Björn Misselwitz and Peter Heuschmann and Commission Health Services Research and Quality Assurance of the German Stroke Society (“Deutsche Schlaganfall Gesellschaft, DSG”)},
journal = {Neurological research and practice},
year = {2026},
month = oct,
doi = {10.1186/s42466-026-00541-0},
url = {https://europepmc.org/article/MED/42963585},
note = {CC BY},
}
RIS
TY - JOUR
TI - Stroke care in Germany: evidence gaps and priorities for health services research and quality assurance.
AU - Flora Noelle Wiegand
AU - Dirk Bartig
AU - Jürgen Faiss
AU - Christoph Gumbinger
AU - Stephen Kaendler
AU - Tobias Knieß
AU - Peter Kolominsky-Rabas
AU - Felipe A Montellano
AU - Anne Lieb
AU - Tobias Neumann-Haefelin
AU - Christopher Jan Schwarzbach
AU - Hassan Soda
AU - Marco Stein
AU - Inga Sünkeler
AU - Götz Thomalla
AU - Markus Wagner
AU - Björn Misselwitz
AU - Peter Heuschmann
AU - Commission Health Services Research and Quality Assurance of the German Stroke Society (“Deutsche Schlaganfall Gesellschaft, DSG”)
PY - 2026
DA - 2026/10/30
JO - Neurological research and practice
DO - 10.1186/s42466-026-00541-0
UR - https://europepmc.org/article/MED/42963585
AB - Stroke remains one of the leading causes of morbidity and mortality in Germany and worldwide. Within this position paper by the Commission Health Services Research and Quality Assurance of the German Stroke Society, we summarize current data on stroke epidemiology, healthcare delivery, and quality assurance of stroke in Germany, identify evidence and knowledge gaps across the stroke care pathway, and derive priorities for future health services research and quality assurance. Based on registry and routine administrative data, approximately 253,000 incident and recurrent strokes were estimated to occur in Germany in 2023. Although age-standardized stroke mortality rates had declined substantially since the 1980s, this trend has reached a plateau since 2018. Acute care is predominantly administered in certified stroke units, characterized by high process and outcome quality. However, areas for improvement remain in post-acute care and in structured outpatient aftercare, particularly regarding appropriate care for patients with persistent functional impairments and unmet needs. Future research priorities include for example the utilization of real-world data to document long-term outcomes, the expansion of quality assurance to specific entities such as subarachnoid hemorrhage, and the evaluation of telemedical frameworks in pre-hospital settings. Systematic implementation of Patient-Reported Outcome Measures (PROMs) in research and clinical practice could facilitate the identification of unmet needs and the development of patient-centered care models. In light of recent legislative advancements (e.g., the Health Data Use Act, European Health Data Space) and technological innovations (e.g., AI-driven applications), new opportunities are emerging to bolster health services research and further optimize the management of stroke patients.
SN - 2524-3489
ER -