Effectiveness on Patient with and without Stroke Fast Track Program in Phetchaburi

Abstract

This retrospective study examined the situation and effectiveness of urgent care services for patients with ischemic stroke. Data were collected from patients diagnosed with ischemic stroke or cerebral infarction who received treatment at Phra Chomklao Hospital, Phetchaburi Province, between 2019 and 2023, using the HosXP database under the special-case health service funds for ischemic stroke (Stroke Fast Track: SFT). The study included three funding sources: the National Health Security Fund, the Social Security Fund, and the Civil Servant Medical Benefit Fund. Patient service records were analyzed using descriptive statistics. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS), and survival rates within six months after diagnosis were analyzed using the Kaplan–Meier method. Results showed that:

During fiscal years 2019–2023, a total of 6,410 stroke patients were recorded, with a higher prevalence among men, and an increasing trend in both sexes. Among patients who did not receive rtPA, 90% presented with mild to moderate symptoms, while all patients who received rtPA had moderate severity. Effective coverage of stroke patients entering the SFT system was 43.49%, with 68.66% of ischemic stroke patients accessing SFT services. Of these, 23.91% received thrombolytic therapy (rtPA), with a survival rate of 93.56%. Patients with hemorrhagic stroke (ICD-10: I60.0–I62.9) had the lowest six-month survival rate, followed by those with ischemic stroke (ICD-10: I63.0–I63.9). 

The results suggest that expanding coverage through network hospitals is essential to improve access to urgent treatment services (Stroke Fast Track) for patients with ischemic stroke, thereby enhancing survival outcomes.