The Health Insurance Review & Assessment Service (HIRA) for the first time released the results of its acute stroke adequacy assessment that includes treatment for hemorrhagic stroke. For both ischemic and hemorrhagic stroke, most final treatments were performed within the golden time, but fewer than 60% of medical institutions were actually capable of performing endovascular thrombectomy or surgery for subarachnoid hemorrhage.
The Health Insurance Review & Assessment Service (HIRA) on the 30th released the results of the "2024 (11th) acute stroke adequacy assessment." The assessment covered 32,613 cases of acute stroke patients admitted through emergency rooms at 268 or higher-level general hospitals from Oct. last year to Mar. this year.
This assessment expanded the scope beyond the previous ischemic stroke–focused evaluation to include treatment for hemorrhagic stroke. It also, for the first time, disclosed the rate of endovascular thrombectomy within 120 minutes after hospital arrival and the rate of final treatment for subarachnoid hemorrhage within 24 hours.
Among ischemic stroke patients, the rate of endovascular thrombectomy within 120 minutes after hospital arrival was 95.1%. Among hemorrhagic stroke patients, the rate of final treatment for subarachnoid hemorrhage within 24 hours was tallied at 99.9%.
However, actual procedural capacity varied widely by hospital. Among the assessed institutions, 56.7% performed endovascular thrombectomy, and 58.6% performed final treatment for subarachnoid hemorrhage. HIRA said capacity to provide final stroke treatment, a critical component of emergency and severe essential care, differed by institution.
Arrival times to the emergency room also shortened.
The median time from stroke symptom onset to emergency room arrival was 3 hours 28 minutes, down 16 minutes from the previous assessment.
In particular, patients who used the 119 ambulance took 123 minutes to reach the emergency room, while those who did not use an ambulance took 552 minutes. That is a difference of nearly seven hours.
HIRA emphasized that if suspected stroke symptoms such as sudden speech disturbance, unilateral paralysis, or severe headache appear, it is important to be transported quickly via 119, rather than self-transport, to a medical institution capable of providing final treatment.
The average composite score for the 268 medical institutions assessed was 85.17 points.
First-grade institutions with scores of 95 points or higher totaled 112 (41.8%). Among tertiary general hospitals, 45 of 46 received first grade, and among general hospitals, 67 of 222 were first grade.
The "presence of a stroke unit," which evaluates infrastructure for acute stroke treatment, was 44.8%, up 12.7 percentage points from the previous assessment. As more institutions came to have specialists, nurses, and facilities and equipment in place, concentrated stroke care capacity was analyzed to have improved.
Hong Seung-kwon, HIRA president, said, "For stroke, the time from symptom onset to final treatment determines survival and outcomes," adding, "We will continue to improve the adequacy assessment so patients can receive final treatment quickly, and we will also support strengthening medical institutions' treatment capacity."