Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes.

Journal Article (Journal Article;Multicenter Study)

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.

Full Text

Duke Authors

Cited Authors

  • O'Brien, EC; Wu, J; Zhao, X; Schulte, PJ; Fonarow, GC; Hernandez, AF; Schwamm, LH; Peterson, ED; Bhatt, DL; Smith, EE

Published Date

  • February 3, 2017

Published In

Volume / Issue

  • 6 / 2

PubMed ID

  • 28159820

Pubmed Central ID

  • PMC5523738

Electronic International Standard Serial Number (EISSN)

  • 2047-9980

Digital Object Identifier (DOI)

  • 10.1161/JAHA.116.003813


  • eng

Conference Location

  • England