Background: Stroke is a major and increasing health burden worldwide. Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-RA) has proved to be a highly effective therapy for minimizing stroke morbidity and mortality, but given the 4.5 hours optimum treatment window, achieving high rate of rt-PA administration is still a challenging issue.
Objective: The present study aimed to investigate trends in intravenous thrombolysis with recombinant tissue plasminogen activator rates in each Health Area and province in Thailand.
Materials and Methods: The present study used a descriptive retrospective survey design. It used data from Thailand’s National Health Security Office for Universal Health Coverage Scheme patients, 15 years and over with cerebral infarction from budget year 2009 to 2020 (until July, 31st).
Results: The overall rate of rt-PA administration in Thailand increased from 0.18% (57 cases from total 32,421 cases) in 2009 to 7.95% (5,863 cases from total 73,769 cases) in 2020 (until July, 31st). Health Area 11 had the highest rate of rt-PA administration (10.82%, 559 out of 5,165 cases), with Health Area 9 having the lowest rate (6.19%, 548 out of 8,849 cases).
Conclusion: From 2009 to 2020, rate of the rt-PA treatment in Thai Universal Health Coverage Scheme patients, 15 years and over, steadily increased. In order to achieve higher rates of rt-PA treatment, further studies are needed to address the barriers of rt-PA treatment for further systematic development of acute stroke care.

Keywords: Recombinant tissue plasminogen activator; Treatment rate; Acute stroke; Cerebral infarction