J Korean Neurol Assoc.
2023 Feb;41(1):18-30. 10.17340/jkna.2023.1.3.
Quality of Acute Stroke Care within Emergency Medical Service System in Korea: Proposal for Severe Emergency Medical Center
- Affiliations
-
- 1Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- 2Clinical Research Center, Asan Medical Center, Seoul, Koreaa
- 3Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- 4Department of Neurology, Seoul National University Hospital, Seoul, Korea
- 5Department of Neurology, Korea University Guro Hospital, Seoul, Korea
- 6Department of Neurology, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Korea
- 7Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
- 8Department of Neurology, Kangwon National University Hospital, Chuncheon, Korea
- 9Department of Neurology, Chungnam National University Sejong Hospital, Sejong, Korea
- 10Department of Neurology, National Medical Center, Seoul, Koreai
- 11Department of Neurology, Ulsan University Hospital, Ulsan, Korea
- 12Departments of Neurology, Chosun University Hospital, Gwangju, Korea
- 13Department of Neurology, Inha University Hospital, Incheon, Korea
- 14Department of Neurology, Seoul Medical Center, Seoul, Korea
- 15Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
- 16Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea
- 17Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
- 18Department of Neurology, Dong-A University Hospital, Busan, Korea
- 19Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
- 20Healthcare Review and Assessment Committee, Health Insurance Review & Assessment Service, Wonju, Korea
- 21Quality Assessment Department, Health Insurance Review & Assessment Service, Wonju, Korea
- 22Quality Assessment Administration Department, Health Insurance Review & Assessment Service, Wonju, Korea
- KMID: 2539083
- DOI: http://doi.org/10.17340/jkna.2023.1.3
Abstract
- Background
Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas.
Methods
This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis.
Results
In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively).
Conclusions
There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.
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