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328685
Successful Implementation of Chronic Disease Management by a Government-led Regional Cardiocerebrovascular Center in Korea


Monday, November 2, 2015

Yu-Mi Lee, MD, Department of Preventive Medicine and Public Health, School of Medicine, Kyungpook National University, Daegu, Korea, Republic of (South)
Keon-Yeop Kim, MD, PhD, Department of Preventive Medicine and Public Health, School of Medicine, Kyungpook National University, Daegu, Korea, Republic of (South)
Sin Kam, MD, PhD, Department of Preventive Medicine and Public Health, School of Medicine, Kyungpook National University, Daegu, Korea, Republic of (South)
Nam-Soo Hong, MD, Department of Preventive Medicine and Public Health, School of Medicine, Kyungpook National University, Daegu, Korea, Republic of (South)
Seon-Hwa Lee, MS, Department of Preventive Medicine and Public Health, School of Medicine, Kyungpook National University, Daegu, Korea, Republic of (South)
Su-Jin Lee, MS, Department of Preventive Medicine and Public Health, School of Medicine, Kyungpook National University, Daegu, Korea, Republic of (South)
Background and objective: Acute myocardial infarction (AMI) and stroke are the leading causes of death in Korea. From 2008, the Ministry of Health and Welfare in Korea initiated and financially supported Regional Cardiocerebrovascular Centers (RCCVC) in 11 different regions to improve the quality of management for patients with AMI and stroke.

Methods: The RCCVCs provide a comprehensive and systematic care system for patients with AMI and ischemic stroke, which includes the following: development and monitoring the critical pathways (CP) for hyperacute AMI and ischemic stroke; operation and maintenance of the stroke unit/coronary care unit; availability of 24-hour on-call specialists; early rehabilitation; and one-to-one education programs for secondary prevention of disease. Of the 11 RCCVCs, we describe here the performance of Daegu-Gyeongbuk RCCVC (DG-RCCVC), which commenced operations in 2008.

Results: An average of 565 AMI and 739 ischemic stroke patients are admitted to DG-RCCVC annually. The percentage of primary PCIs executed within 90 minutes of patient arrival rose from 86.3% (2008) to 100% (2014). The average time for a patient from arrival at the emergency room to receiving primary PCI decreased from 72.6 minutes (2008) to 54.7 minutes (2014). The proportion of patients who underwent initial brain imaging within one hour of arriving at the emergency room increased from 48.1% (2008) to 96.8% (2014). The median time for a patient from arrival at the emergency room to being treated with an intravenous thrombolysis (IV-tPA) decreased from 42.5 minutes in 2008 (57 minutes in 2009) to 40 minutes in 2014.

Conclusion: The successful achievement of this government-supported RCCVC is a good example of effective management of acute cardiocerebrovascular disease at the in-hospital stage.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Public health or related public policy

Learning Objectives:
Describe achievements relating to cardiocerebrovascular disease management during the in-hospital stage following the establishment of regional cardiocerebrovascular center (RCCVC) in Korea

Keyword(s): Chronic Disease Management and Care, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I specialized in preventive mecidine and have participated in management of Regional Cardiocerebrovascular center as a supervisor. I have been the principal investigator or co-worker of government-funded grants focusing on the community health program development project and nationa level data study project. My scientific interests has been the health promotion and building a healthy community.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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