Association between Prehospital Visits and Poor Health Outcomes in Korean Acute Stroke Patients: A National Health Insurance Claims Data Study

Jinyoung Shin, Hyeongsu Kim (), Youngtaek Kim, Jusun Moon, Jeehye Lee, Sungwon Jung, Rahil Hwang and Mi Young Kim
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Jinyoung Shin: Department of Family Medicine, School of Medicine, Konkuk University, Seoul 05029, Republic of Korea
Hyeongsu Kim: Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul 05029, Republic of Korea
Youngtaek Kim: Department of Preventive Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
Jusun Moon: Department of Neurology, National Medical Center, Seoul 04564, Republic of Korea
Jeehye Lee: National Emergency Medical Center, National Medical Center, Seoul 04564, Republic of Korea
Sungwon Jung: Department of Nursing, Fareast University, Eumseong 27601, Republic of Korea
Rahil Hwang: Department of Nursing, College of Nursing, Shinhan University, Uijeongbu 11644, Republic of Korea
Mi Young Kim: Department of Nursing, College of Nursing, Hanyang University, Seoul 15588, Republic of Korea

IJERPH, 2023, vol. 20, issue 3, 1-9

Abstract: This study aimed to determine whether prehospital visits to other medical institutions before admission are associated with prolonged hospital stay, readmission, or mortality rates in acute stroke patients. Using the claims data from the Korean Health Insurance Service, a cross-sectional study was conducted on 58,418 newly diagnosed stroke patients aged ≥ 20 years from 1 January 2019 to 31 December 2019. Extended hospital stay (≥7 days; median value) following initial admission, readmission within 180 days after discharge, and all-cause mortality within 30 days were measured as health outcomes using multiple logistic regression analysis after adjusting for age, sex, income, residential area, and medical history. Stroke patients with a prehospital visit (10,992 patients, 18.8%) had a higher risk of long hospitalization (odds ratio = 1.06; 95% confidence interval = 1.02–1.10), readmission (1.19; 1.14–1.25), and mortality (1.23; 1.13–1.33) compared with patients without a prehospital visit. Female patients and those under 65 years of age had increased unfavorable outcomes ( p < 0.05). Prehospital visits were associated with unfavorable health outcomes.

Keywords: stroke; delayed diagnosis; length of stay; patient readmission; mortality; administrative claims; health care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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