Trends in Prehospital Visits as a Cause of Delayed Admission in Korean Stroke Patients over a 10-Year Period: A National Health Insurance Claims Data Study

TL;DR

This study analyzed trends in prehospital visits among Korean stroke patients from 2010 to 2019, finding a decrease in such visits but still significant delays in admission.

Contribution

The study provides a 10-year national analysis of prehospital visits and their impact on admission delays in stroke patients.

Findings

The prehospital visits rate decreased from 25.1% in 2010 to 17.8% in 2019.

Despite the decline, over 10,000 patients still visited other institutions before admission.

Younger, female, and higher-income patients in low urbanization areas had higher prehospital visit rates.

Abstract

A prehospital delay from symptom onset to hospital arrival
resulted in stroke-related complications or in-hospital deaths in acute stroke
patients. We aimed to investigate trends in prehospital visits as a cause of
prehospital delay using data from the Korean Health Insurance Service.

This nationwide, population-based, retrospective cohort study
included 524,524 newly-diagnosed stroke patients admitted via the emergency
departments of secondary and tertiary hospitals. We obtained the prehospital
visits rate from 2010 to 2019 and identified the related characteristics.

Prehospital visits were observed in 111,465 patients (21.3%).
The prehospital visits rate decreased from 25.1% in 2010 to 17.8% in 2019, but
the number of patients increased from 11,255 cases in 2010 to 11,747 cases in
2019. Fortunately, the rate of delayed admission for more than one day decreased
from 26.7% to 21.3%. However, 10.4% of patients were diagnosed more than two
days later. Young, females, or patients with higher income status and living in
low urbanization areas exhibited a higher rate of prehospital visits.

Prehospital visits in Korean stroke patients decreased from
25.1% in 2010 to 17.8% in 2019. However, more than 10,000 patients still
visited other medical institutions before admission to treatment.

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