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Stroke prevention and control system in China: CSPPC-Stroke Program
Bao-Hua Chao1, Feng Yan2, Yang Hua2
1The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China.
Insights
China
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.
Abstract:
In China, stroke is a major cause of mortality, and long-term physical and cognitive impairment. To meet this challenge, the Ministry of Health China Stroke Prevention Project Committee (CSPPC) was established in April 2011. This committee actively promotes stroke prevention and control in China. With government financial support of 838.4 million CNY, 8.352 million people from 536 screening points in 31 provinces have received stroke screening and follow-up over the last seven years (2012-2018). In 2016, the CSPPC issued a plan to establish stroke centers. To shorten the pre-hospital period, the CSPPC established a stroke center network, stroke map, and stroke "Green Channel" to create three 1-h gold rescue circles, abbreviated as "1-1-1" (onset to call time <1 h; pre-hospital transfer time < 1 h, and door-to-needle time < 1 h). From 2017 to 2018, the median door-to-needle time dropped by 4.0% (95% confidence interval (CI), 1.4-9.4) from 50 min to 48 min, and the median onset-to-needle time dropped by 2.8% (95% CI, 0.4-5.2) from 180 min to 175 min. As of 31 December 2018, the CSPPC has established 380 stroke centers in mainland China. From 1 November 2018, the CSPPC has monitored the quality of stroke care in stroke center hospitals through the China Stroke Data Center Data Reporting Platform. The CSPPC Stroke program has led to a significant improvement in stroke care. This program needs to be further promoted nationwide.
