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European Stroke Journal, 2019. 0(0), 1-10, DOI: https://doi.org/10.1177/2396987319849983
Quality of acute stroke care in Korea(2008-2014): Retrospective analysis of the nationwide and nonselective data for quality of acute stroke care
Hong-Kyun Park, Seong-Eun Kim;Yong-Jin Cho;Jun Yup Kim;Hyunji Oh;Beom Joon Kim;Jihoon Kang;Keon-Joo Lee;Min Uk Jang;Jong-Moo Park;Kwang-Yeol Park;Kyung Bok Lee;Soo Joo Lee;Ji Sung Lee;Juneyoung Lee;Ki Hwa Yang;Ah Rum Choi;Mi Yeon Kang;Eric E Smith;Philip B Gorelick and Hee-Joon Bae
Background: There is limited information about non-selective and contemporary data on quality of stroke care and itsvariation among hospitals at a national level.
Patients and methods: We analysed data of the patients admitted to 258 acute stroke care hospitals covering the entirecountry from the Acute Stroke Quality Assessment Program, which was performed by the Health Insurance Review andAssessment Service from 2008 to 2014 in South Korea. The primary outcome measure was defect-free stroke care (all-ornone),based on six get with the guidelines-stroke performance measures (except venous thromboembolism prophylaxis).
Results: Among 43,793 acute stroke patients (mean age, 67 ±14 years; male, 55%), 31,915 (72.9%) werehospitalised due to ischaemic stroke. At a patient level, defect-free stroke care steadily increased throughout the studyperiod (2008, 80.2% vs. 2014, 92.1%), but there were large disparities among hospitals (mean=50.7%,SD=21.7%). Defect-free stroke care was given more frequently in patients being treated in hospitals with 25 ormore stroke cases per month (odds ratio [OR] 2.83; 95% confidence interval [CI] 1.69–4.72), delivery of intravenousthrombolysis one or more times per month (OR 2.37; 95% CI 1.44–3.92), or provision of stroke unit care (OR 1.75;95% CI 1.22–2.52).
Discussion: This study shows that the quality of stroke care in Korea is improving over time and is higher in centreswith a larger volume of stroke or intravenous thrombolysis cases and providing stroke unit care but hospital disparitiesexist.
Conclusion: Reducing large differences in defect-free stroke care among acute stroke care hospitals should be continuouslypursued.
- DOI: https://doi.org/10.1177/2396987319849983
- ISBN or ISSN: 0197-4580
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.