TY - JOUR
T1 - Healthcare resource availability, quality of care, and acute ischemic stroke outcomes
AU - O'Brien, Emily C.
AU - Wu, Jingjing
AU - Zhao, Xin
AU - Schulte, Phillip J.
AU - Fonarow, Gregg C.
AU - Hernandez, Adrian F.
AU - Schwamm, Lee H.
AU - Peterson, Eric D.
AU - Bhatt, Deepak L.
AU - Smith, Eric E.
N1 - Publisher Copyright:
© 2017 The Authors.
PY - 2017
Y1 - 2017
N2 - Background-Healthcare resources vary geographically, but associations between hospital-based resources and acute stroke quality and outcomes remain unclear. Methods and Results-Using Get With The Guidelines-Stroke and Dartmouth Atlas of Health Care data, we examined associations between healthcare resource availability, stroke care, and outcomes. We categorized hospital referral regions with high-, medium-, or low-resource levels based on the 2006 national per-capita availability median of 6 relevant acute stroke care resources. Using multivariable logistic regression, we examined healthcare resource level and in-hospital quality and outcomes. Of 1 480 308 admitted ischemic stroke patients (2006-2013), 28.8% were hospitalized in low-, 44.4% in medium-, and 26.9% in high-resource hospital referral regions. Quality-of-care/timeliness metrics, adjusted length of stay, and in-hospital mortality were similar across all resource levels. Conclusions-Significant variation exists in regional availability of healthcare resources for acute ischemic stroke treatment, yet among Get With the Guidelines-Stroke hospitals, quality of care and in-hospital outcomes did not differ by regional resource availability.
AB - Background-Healthcare resources vary geographically, but associations between hospital-based resources and acute stroke quality and outcomes remain unclear. Methods and Results-Using Get With The Guidelines-Stroke and Dartmouth Atlas of Health Care data, we examined associations between healthcare resource availability, stroke care, and outcomes. We categorized hospital referral regions with high-, medium-, or low-resource levels based on the 2006 national per-capita availability median of 6 relevant acute stroke care resources. Using multivariable logistic regression, we examined healthcare resource level and in-hospital quality and outcomes. Of 1 480 308 admitted ischemic stroke patients (2006-2013), 28.8% were hospitalized in low-, 44.4% in medium-, and 26.9% in high-resource hospital referral regions. Quality-of-care/timeliness metrics, adjusted length of stay, and in-hospital mortality were similar across all resource levels. Conclusions-Significant variation exists in regional availability of healthcare resources for acute ischemic stroke treatment, yet among Get With the Guidelines-Stroke hospitals, quality of care and in-hospital outcomes did not differ by regional resource availability.
KW - Healthcare resources
KW - Outcomes research
KW - Stroke care
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U2 - 10.1161/JAHA.116.003813
DO - 10.1161/JAHA.116.003813
M3 - Article
C2 - 28159820
AN - SCOPUS:85016083338
SN - 2047-9980
VL - 6
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 2
M1 - e003813
ER -