Stroke presentation and hospital management: comparison of neighbouring healthcare systems with differing health policies.

Background: Acute stroke care is shaped by healthcare policies. Differing policies in similar populations allow for assessment of policy impact on health and healthcare outcomes. Aims: To compare stroke presentation and hospital care in two adjacent healthcare systems with differing healthcare policies. Methods: Interviews and chart review of consecutive acute stroke admissions in Northern Ireland (n=103) and the Republic of Ireland (n=100). Results: Marked regional contrasts were evident for key aspects of hospital care. Northern Ireland performed significantly better on 15 of 16 quality of care (Sentinel Audit) items. Delivery on standards was significantly better in Northern Ireland for early assessment (Northern Ireland 72%; Republic of Ireland 54%, p

Social Inclusion or Market Competitiveness? A Comparison of Rural Development Policies in the European Union and the United States

The language of EU rural development policy appears more interested in social inclusion and that of US policy more interested in market competitiveness. We seek to determine why policies directed at rural development in the EU and the USA differ. In both contexts new rural development policies emphasize partnership and participation but we find local participation is used to promote social inclusion in the EU and market competitiveness in the USA. An examination of these dimensions illustrates important transcontinental differences and similarities in rural development policies. We explore the socio-historical reasons for differences in the commitment to social inclusion, while also noting similarities in the priority of market competitiveness.