HEALTHCARE QUALITY OF TIMEDEPENDENT DISEASES DURING COVID-19 EPIDEMIC: THE EXPERIENCE IN STROKE

ABSTRACT

Background: The study aimed to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on the healthcare quality of acute ischemic stroke (AIS) patients and summarize the potential experience in response to the COVID-19 outbreak. Methods: We continuously included AIS patients registered in the CASE-II before and during the COVID-19 pandemic. We investigated the changes of 15 key performance indicators (KPIs),the composite score developed from these KPIs, and in-hospital outcomes of AIS during the COVID-19 outbreak and analyzed potential causes of these changes. Results: There were 5,854 AIS patients admitted in pandemic period (January 23 to April 30, 2020) and 6,807 patients in pre-pandemic period (November 1, 2019 to January 22, 2020) among 52 hospitals. The median onset-to-door time was 28 minutes longer in pandemic than in prepandemic period (189 [90-585] versus 161 [87-417] minutes;P=0.001), but the proportion of patients receiving reperfusion treatment and the door-to-treatment time did not differ between the two groups. The composite measure (92.5% versus 91.4%;P=0.165) and all-or-none measure (54.4% versus 50.6%;P=0.893) did not significantly differ between the two periods. The rate of antithrombotic at discharge, smoking cessation and stroke education increased by 1.2% (P=0.025) and 1.5% (P=0.001), respectively during pandemic. There was also no significant difference between the two groups in mRS score at discharge (P=0.532) and new clinical vascular events (P=0.069). Conclusions: Although AIS inpatients decreased during COVID-19 pandemic, the healthcare quality for hospitalized stroke patients was not significantly affected. This might be attributed to the health information technology and the effective prevention measures of COVID-19.