RT Journal Article
SR Electronic
T1 Patient profiles contribute to differences in quality metrics of stroke centers
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 292
OP 300
DO 10.17712/nsj.2020.4.20190100
VO 25
IS 4
A1 Ungerer, Matthias
A1 Begli, Nima Haji
A1 Heyse, Miriam
A1 Purrucker, Jan
A1 Regula, Jens
A1 Berberich, Anne
A1 Ciolli, Ludovico
A1 Nagel, Simon
A1 Ringleb, Peter
A1 Gumbinger, Christoph
YR 2020
UL http://nsj.org.sa/content/25/4/292.abstract
AB Objectives: To examine this association by comparing patient profiles in 2 closely affiliated hospitals and by examining their association with quality metrics.Methods: We performed a retrospective cohort study comparing a university level comprehensive stroke centers (CSC) with its teaching hospital and local stroke unit (LSU) using routinely collected quality assurance data over a 2 year period. Both hospitals were closely affiliated, shared important resources and medical staff rotated amongst both hospitals. We compared patient profiles as well as internationally recognized quality metrics and examined the association of profiles with quality metrics.Results: A total of 2,462 patients were treated in the CSC and 726 in the LSU. The LSU had a longer door-to-image and door-to-needle times. Rate of systemic thrombolysis was lower in the LSU. Patient profiles differed significantly and were associated with door-to-image and door-to-needle times as well as intravenous thrombolysis rates, even when adjusted for stroke service level. The diagnostic procedures for stroke work-up were similar. Discharge management differed strongly.Conclusion: Although LSUs and CSCs are the primary care providers in their respective regions, differences in patient profiles may contribute to differences in performance parameters. Adjusting for patient profiles may improve the comparability of the quality of stroke care provided by hospitals belonging to different stroke service levels.