Stroke prevention and control system in China: CSPPC-Stroke Program

Area of Science:

• Public Health
• Neurology
• Health Services Research

Background:

• Stroke is a leading cause of death and disability in China.
• The China Stroke Prevention Project Committee (CSPPC) was established in 2011 to address this challenge.
• Significant government funding supports stroke prevention and control initiatives.

Purpose of the Study:

• To evaluate the impact of the CSPPC's stroke prevention and control program.
• To assess the establishment and effectiveness of stroke centers and associated networks.
• To analyze improvements in stroke care metrics, including pre-hospital and door-to-needle times.

Main Methods:

• Implementation of a national stroke center network and a "Green Channel" system.
• Establishment of three "1-hour gold rescue circles" focusing on onset-to-call, pre-hospital transfer, and door-to-needle times.
• Monitoring of stroke care quality via the China Stroke Data Center Data Reporting Platform.
• Analysis of stroke screening and follow-up data for millions of individuals (2012-2018).

Main Results:

• Over 8.3 million people received stroke screening and follow-up across 31 provinces.
• 380 stroke centers were established by December 2018.
• Median door-to-needle time decreased by 4.0% (50 to 48 minutes) from 2017-2018.
• Median onset-to-needle time decreased by 2.8% (180 to 175 minutes) from 2017-2018.

Conclusions:

• The CSPPC Stroke program has significantly improved stroke care in China.
• The "1-1-1" initiative and stroke center network show positive impacts on treatment times.
• Nationwide promotion and continued monitoring are recommended for further advancements in stroke care.