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

Publication ,  Journal Article
O'Brien, EC; Wu, J; Zhao, X; Schulte, PJ; Fonarow, GC; Hernandez, AF; Schwamm, LH; Peterson, ED; Bhatt, DL; Smith, EE
Published in: J Am Heart Assoc
February 3, 2017

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.

Duke Scholars

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

February 3, 2017

Volume

6

Issue

2

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Quality of Health Care
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
 

Citation

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Chicago
ICMJE
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O’Brien, E. C., Wu, J., Zhao, X., Schulte, P. J., Fonarow, G. C., Hernandez, A. F., … Smith, E. E. (2017). Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes. J Am Heart Assoc, 6(2). https://doi.org/10.1161/JAHA.116.003813
O’Brien, Emily C., Jingjing Wu, Xin Zhao, Phillip J. Schulte, Gregg C. Fonarow, Adrian F. Hernandez, Lee H. Schwamm, Eric D. Peterson, Deepak L. Bhatt, and Eric E. Smith. “Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes.J Am Heart Assoc 6, no. 2 (February 3, 2017). https://doi.org/10.1161/JAHA.116.003813.
O’Brien EC, Wu J, Zhao X, Schulte PJ, Fonarow GC, Hernandez AF, et al. Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes. J Am Heart Assoc. 2017 Feb 3;6(2).
O’Brien, Emily C., et al. “Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes.J Am Heart Assoc, vol. 6, no. 2, Feb. 2017. Pubmed, doi:10.1161/JAHA.116.003813.
O’Brien EC, Wu J, Zhao X, Schulte PJ, Fonarow GC, Hernandez AF, Schwamm LH, Peterson ED, Bhatt DL, Smith EE. Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes. J Am Heart Assoc. 2017 Feb 3;6(2).
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

February 3, 2017

Volume

6

Issue

2

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Quality of Health Care
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Humans