RT Journal Article
SR Electronic
T1 Community-based stroke system of care improves patient outcomes in Chinese rural areas
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP jech-2017-210185
DO 10.1136/jech-2017-210185
A1 Mingli He
A1 Jin’e Wang
A1 Qing Dong
A1 Niu Ji
A1 Pin Meng
A1 Na Liu
A1 Shan Geng
A1 Sizhou Qin
A1 Wenyan Xu
A1 Chuantong Zhang
A1 Dabo Li
A1 Huamin Zhang
A1 Jinping Zhu
A1 Hua Qin
A1 Rutai Hui
A1 Yibo Wang
YR 2018
UL http://jech.bmj.com/content/early/2018/03/06/jech-2017-210185.abstract
AB Background Building effective and efficient stroke care systems is a key step in improving prevention, treatment and rehabilitation of stroke. The aim of this study was to evaluate the effectiveness of this stroke system of care on stroke management during a 2-year follow-up.Methods A stroke system of care was developed from November 2009 to November 2010 in three townships in Ganyu County. Additional three matched townships were invited as controls. We first investigated the stroke incidence of these populations. Subsequently, this stroke system of care and an educational campaign in the three intervention townships were implemented and the effectiveness of the system was evaluated in the next 2 years.Results At postintervention, more patients in the intervention communities obtained stroke knowledge and then the proportion of patients with stroke who were admitted within 3 hours of onset markedly increased in 2012 (12.0% vs 8.1%, p=0.044) and in 2013 (15.2% vs 9.7%, p=0.008) compared with those in the control communities. In the intervention communities, this proportion of patients with acute ischaemic stroke who received thrombolytic treatment was markedly raised from 2.1% in 2012 to 3.0% in 2013. More importantly, the fatality rate substantially decreased in 2013 in the intervention communities compared with that in the control communities (6.1% vs 9.7%, p=0.032). Similarly, the disability rate significantly decreased in 2013 (45.3% vs 51.5%, p=0.045).Conclusions The community-based stroke system of care was effective and practical for optimising stroke treatments and improving patient outcomes.Trial registration number ChiCTR-RCH-13003408, Post-results.