Neurological Sciences

, Volume 34, Issue 12, pp 2193–2198 | Cite as

Need for neurology specialists to be dedicated to hospital care in Italy

Original Article


Any patients admitted to healthcare facilities with a neurological diseases deserves to be managed by a neurologist. This is particularly important for acute onset neurological disorders, because of their severity and the requirement of early and appropriate diagnostic–therapeutic approach. In addition, this may reduce both unnecessary admissions and length of stay, with a significant saving of resources for the National Health System (NHS). To ensure this, it is important to evaluate predictable needs for hospital neurologists in Italy. The hospital discharges for neurological medical diseases of the Major Disease Category (MDC) 1 were 455,132 in 2009 and 491,836 in 2008, more than 50 % of which were acute neurological disorders. Stroke and transient ischemic attacks (TIA) accounted for about 170,000 per year. Currently available neurologists in Italian healthcare facilities are largely insufficient to assist such a large number of patients. The 270 Neurological Care Units in Italy (of which 243 open to the emergency care) are equipped with an average number of 7.7 neurologists per unit, inadequate to ensure on duty care 24 h a day, 7 days a week. In addition, the mean age of hospital neurologists is quite high, with provision for large retirement. It is therefore required to increase in the next few years the number of neurologists by at least 30 %, with an increase of 562 units. To meet the need for neurology specialists committed to hospital care in Italy is also necessary to increase the number of scholarships for residents in post-graduate schools.


Neurology manpower Neurology education Postgraduate training Neurological acute diseases 


  1. 1.
    Gómez Ibáñez A, Irimía P, Martínez-Vila E (2008) The problem of neurological emergencies and the need for specific neurology shift. An Sist Sanit Navar 31:7–13PubMedGoogle Scholar
  2. 2.
    Hanley DF, Hacke W (2004) Critical care and emergency medicine neurology. Stroke 35:365–366PubMedCrossRefGoogle Scholar
  3. 3.
    Morgenstern LB, Huber JC, Luna-Gonzales H, Saldin KR, Grotta JC, Shaw SG, Knudson L, Frankowski RF (2001) Headache in the emergency department. Headache 41:537–541PubMedCrossRefGoogle Scholar
  4. 4.
    Moulin T, Sablot D, Vidry E, Belahsen F, Berger E, Lemounaud P, Tatu L, Vuillier F, Cosson A, Revenco E, Capellier G, Rumbach L (2003) Impact of emergency room neurologists on patient management and outcome. Eur Neurol 50:207–214PubMedCrossRefGoogle Scholar
  5. 5.
    Roberts K, Costelloe D, Hutchinson M, Tubridy N (2007) What difference does a neurologist make in a general hospital? Estimating the impact of neurology consultations on in-patient care. Ir J Med Sci 176:211–214PubMedCrossRefGoogle Scholar
  6. 6.
    Moeller JJ, Kurniawan J, Gubitz GJ, Ross JA, Bhan V (2008) Diagnostic accuracy of neurological problems in the emergency department. Can J Neurol Sci 35:335–341PubMedGoogle Scholar
  7. 7.
    Rapporto Annuale sull’Attività di Ricovero Ospedaliero. (2011). Health informatics system of italian ministry of health. (Accessed 01 Mar 2013)
  8. 8.
    De Falco FA, Sterzi R, Toso V, Consoli D, Guidetti D, Provinciali L, Leone MA, Beghi E (2007) Indagine epidemiologica italiana su “la Neurologia nell’emergenza-urgenza”: il Progetto NEU. Neurol Sci 28:S1–S36Google Scholar
  9. 9.
    Consoli D, de Falco FA, Lenzi GL, Micieli G, Oleari F, Palumbo F, Rosati G, Simonetti G, Stanzione P, Zangrillo A (2010). Le risorse del Servizio Sanitario Nazionale, In: Organizzazione dell’assistenza all’ictus cerebrale: le Stroke Units. Quaderni del Ministero della Salute, n. 2. (Accessed 01 Mar 2013)
  10. 10.
    Luengo-Fernandez R, Gray AM, Rothwell PM (2009) Effect of urgent treatment for transient ischaemic attack and minor stroke on disability and hospital costs (EXPRESS study): a prospective population-based sequential comparison. Lancet Neurol 8:235–243PubMedCrossRefGoogle Scholar
  11. 11.
    Sheth KN, Drogan O, Manno E, Geocadin RG, Ziai W (2012) Neurocritical care education during neurology residency: AAN survey of US program directors. Neurology 78:1793–1796PubMedCrossRefGoogle Scholar
  12. 12.
    Da Silva IR, Gomes JA (2013) Residency training: the role of neurocritical care in resident education. Neurology 80:e51–e53PubMedCrossRefGoogle Scholar
  13. 13.
    Stone K (2009) When seconds count: tackling neurological emergencies. Lancet Neurol 8:702–703PubMedCrossRefGoogle Scholar
  14. 14.
    Josephson SA, Engstrom JW, Wachter RM (2008) Neurohospitalists: an emerging model for inpatient neurological care. Ann Neurol 63:135–140PubMedCrossRefGoogle Scholar
  15. 15.
    Chang I, Pratt RW (2012) Neurohospitalists: an emerging subspecialty. Curr Neurol Neurosci Rep 12:481–488PubMedCrossRefGoogle Scholar
  16. 16.
    Bergen DC, Good D (2006) Neurology training programs worldwide: a world federation of neurology survey. J Neurol Sci 246:59–64PubMedCrossRefGoogle Scholar
  17. 17.
    Struhal W, Sellner J, Lisnic V, Vécsei L, Müller E, Grisold W (2011) Neurology residency training in Europe––the current situation. Eur J Neurol 18:e36–e40PubMedCrossRefGoogle Scholar
  18. 18.
    Bereczki D, Csiba L, Komoly S, Vécsei L (2010) Endangered future: education and replacement of specialists in neurology––a survey in Hungary. Ideggyogy Sz 63:259–265PubMedGoogle Scholar
  19. 19.
    The Lancet Neurology (2011) UK neurological care: time to confront the crisis. Lancet Neurol 10: 671Google Scholar
  20. 20.
    Warlow C, Humphrey P, Venables G (2002) UK neurologists and the care of adults with acute neurological problems. Clin Med 2:436–439PubMedCrossRefGoogle Scholar
  21. 21.
    Carroll C, Zajicek J (2004) Provision of 24-hour acute neurology care by neurologists: manpower requirements in the UK. J Neurol Neurosurg Psychiatry 75:406–409PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  1. 1.Neurology Care UnitLoreto Nuovo HospitalNaplesItaly
  2. 2.Stroke and Neurology UnitCareggi University HospitalFlorenceItaly

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