Development of Seamless Care Service Model for Stroke Patients: Implementation in Roi Et Province

Abstract

Purposes : To analyze the trends and efficiency of stroke service systems using secondary data, Identify service gaps and challenges that need improvement, and propose a seamless stroke care model applicable in Roi Et province and Health Region 7, Thailand.

Study design : Descriptive study with quantitative analysis.

Materials and Methods : Secondary data were retrieved from health inspection reports, Stroke Tour records, and the Health Data Center (HDC) database during 2022–2024. Indicators included the proportion of ischemic stroke patients receiving intravenous rt-PA, mean Door-to-Needle Time (DTN), in-hospital mortality rate, and Tele-stroke coverage. Data were analyzed using descriptive and comparative statistics, and results were presented through tables and graphs.

Main findings : The rt-PA administration rate in Roi Et increased from 10.0% in 2022 to 13.9% in 2024, higher than Health Region 7 (10.5%) and the national average (9.0%). The mean DTN decreased from 74 minutes (2022) to 68 minutes (2024), shorter than the national average (78 minutes). In-hospital mortality in Roi Et decreased from 8.2% to 7.7%, compared with 8.3% nationally. Tele-stroke coverage in Health Region 7 expanded from 65% (18 Node hospitals) in 2022 to 92% (29 Node hospitals) in 2024.

Conclusion and recommendations : The seamless stroke care model in Roi Et and Health Region 7 significantly improved access to timely treatment, reduced DTN, and lowered in-hospital mortality. Investment in CT Scan and Endovascular Therapy (EVT) capacity at Node hospitals, expansion of Tele-stroke systems, workforce training for multidisciplinary stroke teams, and integration of rehabilitation services are recommended to ensure sustainability and nationwide scalability.