Outcomes of Care for Acute Hemorrhagic Stroke Patients Receiving Care with a Stroke Program at the Stroke Unit in Rayong Hospital

Abstract

This retrospective descriptive research aimed to examine the outcomes of care for acute hemorrhagic stroke patients receiving care with a stroke program. The samples consisted of 417 medical records of acute hemorrhagic stroke patients receiving care with a stroke program at the Stroke Unit in Rayong Hospital in the fiscal years 2021 and 2022. The research instrument included the record form of quality of hemorrhagic stroke service in Rayong Hospital, the Barthel Index of Activities of Daily Living with a reliability of .99, and the Modified Rankin Scale (mRS) with a reliability of .84. Data were collected from April to June 2023. Data were analyzed using frequency, percentage, mean, standard deviation, median, interquartile range, and Wilcoxon signed-rank test.

The research results revealed that 1) in the fiscal years 2021 and 2022, the outcomes of care for acute hemorrhagic stroke patients were as follows: The average lengths of stay were 9.20 days (SD = 9.20, Med = 7, IQR = 8) and 11.80 days (SD = 13.60, Med = 7, IQR = 12), respectively; the average costs were 55,676.50 baht per case (SD = 56,574.20, Med = 32,550.63, IQR = 52,446.69) and 67,715.03 baht per case (SD = 74,433.50, Med = 39,506, IQR = 56,509.94), respectively; the rate of readmission within 28 days was 0% in both years. For the complication rates, it was showed that aspirated pneumonia occurred in 1.64% and 0.43%, respectively, while urinary tract infection (UTI) occurred at rates of 2.19% and 1.28%, respectively, the rate of pressure sore were 1.64% and 0%, respectively, as well as the mortality rate were 25.14% and 27.78%, respectively; and 2) in the fiscal years 2021 and 2022, at the discharge day, the patients demonstrated a statistically significantly higher average score from the Barthel Index of Activities of Daily Living than at the first day of admission (Z = -7.500, p < .001 and Z = -9.200, p < .001, respectively), whereas they showed a statistically significantly lower average score from the Modified Rankin Scale than at the first day of admission (Z = -4.200, p < .001 and Z = -3.300, p < .001, respectively).

This research suggests that hospital administrators should promote the establishment of stroke units that provide care for ischemic and hemorrhagic stroke patients in critical condition. It will enhance the quality of care in accordance with standards, reduce mortality rates, and decrease disability levels.