The efficiency of the structural reform of the healthcare system for patients with stroke

Abstract

As of 2024, the Republic of Moldova has implemented a formalized system for the referral, diagnosis, and treatment of patients with stroke, based on clear standards and standardized procedures. This system defines the patient clinical pathway and organizes medical workflows coherently, ensuring continuity and quality of care. The structural model was scientifically developed by a group of national and international experts through a series of focus-group sessions. Based on their recommendations, the national network comprises 11 Primary Stroke Centers, one Comprehensive Stroke Center, and one Multidisciplinary Stroke Center. These facilities are strategically distributed across the country within regional, municipal, and tertiary healthcare institutions [1]. The implementation of this model was officially established through Order no. 870/2023 of the Ministry of Health of the Republic of Moldova on the organization of the national stroke care service [2]. The results achieved indicate a significant increase in patients’ access to specialized services, including reperfusion therapies (intravenous thrombolysis with rt-PA and neuroendovascular interventions), alongside a substantial improvement in clinical quality indicators.