Examining factors associated with pre-admission to discharge of stroke patients Shao-Ping Yuan a , Chiu-Mei Chen b , Hung-Chang Liao c , Ming-Jen Chou a, * a Institute of Medicine, Chung Shan Medical University, Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., Taichung City 40201, Taiwan b Neurological Department, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., Taichung City 40201, Taiwan c School of Health Policy and Management, Chung Shan Medical University, Department of Medical Education, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., Taichung City 40201, Taiwan 1. Introduction A stroke, previously known medically as a cerebrovascular accident, is the rapid development of loss of brain function(s) due to a disturbance in the blood supply to the brain. This can be due to ischemia caused by a blockage or a hemorrhage (Sims & Muyderman, 2009). A stroke is a medical emergency and can cause permanent neurological damage, complications, and even death. Stroke is the leading cause of adult disability in the United States, Europe and Asia, and is the second leading cause of death worldwide, causing 10% of deaths; it may soon become the leading cause of death worldwide (Feigin, 2005). In Taiwan, according to statistics published by the Department of Health, Executive Yuan, from 1986 to 2010, stroke ranked second among all causes of death in Taiwan, with the exception of five years in which it ranked third. It is also the leading cause of adult disability, and is one of the top three diseases in terms of consumption of total healthcare resources in Taiwan. In addition, the standardized mortality ratio for cerebrovascular disease in Taiwan is still higher than that in Japan, Singapore, most Western European countries, and the United States. To date, the mortality rate, incidence, prevalence, and risk factors of stroke have been studied extensively in Taiwan, but few studies have examined the relationship between diagnostic metrics and factors related to stroke. In order to improve the quality of care of acute stroke patients, further improve the prognosis of stroke patients, and implement effective prevention Research in Developmental Disabilities 33 (2012) 1389–1394 A R T I C L E I N F O Article history: Received 26 February 2012 Accepted 28 February 2012 Available online 21 April 2012 Keywords: Stroke Ischemic stroke Hemorrhagic stroke Epidemiology, Caregiver A B S T R A C T Stroke is the second leading cause of death and a major cause of adult disability in Taiwan. This research established correlations between pre-admission and discharge data in stroke patients to promote education of the general public, prevention, treatment and high standards of chronic care. A total of 790 stroke patients at Chung Shan Medical University Hospital from 2007 to 2009 contained in the Taiwan Stroke Registry were included in this study. The patients were classified into two major categories: ischemic and hemorrhagic. Thirteen variables, including time series variables, were explored. Our results showed that age, education, hours from symptom onset to the emergency department (ED) arrival, and length of stay in hospital were significantly associated with stroke incidence. These findings show the present situation and medical quality of medical care for stroke patients in Taiwan. The factors association model may assist in developing a set of improvement plans for the coming year. ß 2012 Elsevier Ltd. All rights reserved. * Corresponding author. E-mail addresses: spyuan@csmu.edu.tw (S.-P. Yuan), chou5@ms9.hinet.net (C.-M. Chen), hcliao@csmu.edu.tw (H.-C. Liao), chou12123@gmail.com (M.-J. Chou). Contents lists available at SciVerse ScienceDirect Research in Developmental Disabilities 0891-4222/$ – see front matter ß 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.ridd.2012.02.027