Can Stroke Network Improve Accessibility of Stroke Fast Track in North-eastern of Thailand?
Somsak Tiamkao1,2
Affiliation : 1 Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 2 Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand
National Health Security Office (NHSO) reported incidence rates of stroke were rising from 163.55 to 318.85 patients per 100,000 populations in 2009 to 2019. The standard treatment for acute ischemic stroke is thrombolytic drug within 4.5 hours of stroke onset. The majority of Thailand population outside Bangkok, have very low chance to receive thrombolytic treatment due to limitation of CT machine and medical personnel. In the Northeastern Thailand, there were 23 million people in 20 provinces. Only 60 neurologists practiced in 16 provinces, 55 neurologists work in government hospital (provincial hospital) and 5 neurologist work in private hospital. There is no any neurologist work in community hospital. To facilitate thrombolytic drug use for acute ischemic stroke should be managed by the internists and emergency physicians instead of neurologists. Therefore, stroke network was set up for improve accessibility of stroke fast track. Roles of the main server hospitals are 1) provide thrombolytic treatment for acute ischemic stroke patients, 2) set up comprehensive stroke unit, 3) set up a clinical guideline for stroke fast track and acute ischemic stroke care for their service areas, 4) be consultant for their client hospitals regarding acute stroke care, 5) monitor the client hospitals and improve the client hospitals’ services, and 6) provide interhospital conferences regarding acute stroke care among main service hospitals and client hospitals yearly.
doi.org/10.35755/jmedassocthai.2021.S01.12279
Keywords : Stroke network, Accessibility, Thrombolytic drug
