Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatmen in Taiwan

doi:10.5853/jos.2016.01655

CNU IR > College of Smart Living > Dept. of Hospital and Health (including master's program) > Periodical Articles > Item 310902800/31714

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Title:	Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatmen in Taiwan
Authors:	Cheng, Tain-Junn Peng, Giia-Sheun Jhao, Wei-Siang Lee, Jiunn-Tay Wang, Tsung-Hsi
Contributors:	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
Keywords:	Ischemic stroke Thrombolysis Tissue-type plasminogen activator Hospital Emergent Capability Accreditation by Level-Stroke Taiwan
Date:	2017-05
Issue Date:	2018-11-30 15:53:56 (UTC+8)
Publisher:	Korean Stroke Soc
Abstract:	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.
Relation:	Journal of Stroke, v.19, n.2, pp.205-212
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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