Current Status and Problems of Stroke Units in Korea: Results of a Nationwide Acute Care Hospital Survey by the Korean Stroke Society

Background: The patients who received organized inpatient care are more likely to survive and to be independent. The benefit is most apparent in units based in a discrete ward, stroke unit (SU). The observed benefit is sufficiently large to warrant efforts of widespread implementation of SU care. The Korean Stroke Society surveyed acute stroke care hospitals to know the density and the distribution of SU in Korea. Methods: One hundred-sixty one acute care hospitals were selected among those included in the 5th Quality Audit in 2014 by the Health Insurance Review and Assessment Service of Korea. A senior director of stroke service in each hospital was chosen and asked about the current status of acute stroke care including SU and major obstacles to establish SU in each hospital. Results: The results of the questionnaire revealed the shortage of a total SU number and markedly uneven distribution of SU between rural and urban area. Most hospitals indicated the absence of the insurance reimbursement for medical service in SU, which served as the fundamental cause of lack of skilled manpower for establishing SU. Conclusions: The state-of-the-art SU, which is properly certified or designated, should be spread out more evenly in Korea for the optimal treatment of public regardless of a residential district. Government should encourage and support for the establishment of SU, which is an important first step toward making it reality.ope