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    標題: Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatmen in Taiwan
    作者: Cheng, Tain-Junn
    Peng, Giia-Sheun
    Jhao, Wei-Siang
    Lee, Jiunn-Tay
    Wang, Tsung-Hsi
    貢獻者: Chi Mei Med Ctr, Dept Neurol
    Chi Mei Med Ctr, Dept Occupat Med
    Chia Nan Univ Pharm & Sci, Coll Recreat & Hlth Management, Dept Hosp & Hlth Care Adm
    Taipei Vet Gen Hosp, Hsinchu Branch, Div Neurol, Dept Internal Med
    Minist Hlth & Welf, Dept Med Affairs
    Tri Serv Gen Hosp,Natl Def Med Ctr, Dept Neurol
    Minist Hlth & Welf
    關鍵字: Ischemic stroke
    Thrombolysis
    Tissue-type plasminogen activator
    Hospital Emergent Capability Accreditation by Level-Stroke
    Taiwan
    日期: 2017-05
    上傳時間: 2018-11-30 15:53:56 (UTC+8)
    出版者: Korean Stroke Soc
    摘要: Background and Purpose Recombinant tissue plasminogen activator (rtPA) is one of the proven therapies that improve the outcome of patients with acute ischemic stroke (AIS). In 2009, the Ministry of Health and Welfare, Executive Yuan, Republic of China, launched the project "Hospital Emergent Capability Accreditation by Level-Stroke (HECAL-Stroke)" to improve AIS treatment in Taiwan. The current study was performed to determine whether the project launched by the government was effective in promoting rtPA therapy among AIS patients. Methods All participating hospitals were verified and designated as "heavy duty (HD)," "moderate duty (MoD)," or "medium duty (MeD)" according to the stroke center criteria. Four annual indices (rates of treatment, protocol adherence, in-time treatment, and complications) were recorded from 2009 to 2014 as outcome measures. The data were analyzed using the chi(2) test for significance. Results The number of certified hospitals progressively increased from 74 to 112 during the 6-year period and finally consisted of 33 HD, 9 MoD and 70 MeD hospitals in 2014. The annual intravenous rtPA treatment rate increased significantly from 3.0% in 2009 to 4.5% in 2014. The protocol adherence rates were 95.7% in the HD group, 92.4% in the MoD group and 72.8% in the MeD group. The annual in-time treatment rate significantly improved from 26.0% in 2009 to 60.1% in 2014. The overall symptomatic intracranial hemorrhagic rate after rtPA treatment was 8.6%. Conclusions Initiation of the HECAL-Stroke project by the government significantly improved rtPA treatment in Taiwan.
    關聯: Journal of Stroke, v.19, n.2, pp.205-212
    顯示於類別:[醫務管理系(所)] 期刊論文

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