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 - Funding Information:
We thank Erin Hanley, MS, Duke Clinical Research Institute, for editorial assistance and article preparation. She did not receive compensation for her assistance apart from her employment at the institution where the study was conducted. The authors would like to thank the staffand participants of the Get With The Guidelines-Stroke Registry for their important contributions to this work. The American Heart Association funded Get With The Guidelines-Stroke. The program has been supported in part by unrestricted educational grants to the American Heart Association by Pfizer, Inc., New York, NY, and the Merck-Schering Plough Partnership (North Wales, PA). This project was funded by the American Heart Association's Young Investigator Database Research Seed Grant.
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 -