How do patients pass through stroke services? Identifying stroke care pathways using national audit data.

Clinical Rehabilitation
Matthew GittinsSarah Tyson

Abstract

To map and describe how patients pass through stroke services. Data from 94,905 stroke patients (July 2013-July 2015) who were still inpatients 72 hours after hospital admission were extracted from a national stroke register and were used to identify the routes patients took through hospital and community stroke services. We sought to categorize these routes through iterative consultations with clinical experts and to describe patient characteristics, therapy provision, outcomes and costs within each category. We identified 874 routes defined by the type of admitting stroke team and subsequent transfer history. We consolidated these into nine distinct routes and further summarized these into three overlapping 'pathways' that accounted for 99% of the patients. These were direct discharge (44%), community rehabilitation (47%) and inpatient transfer (19%) with 12% of the patients receiving both inpatient transfer and community rehabilitation. Patients with the mildest and most severe strokes were more likely to follow the direct discharge pathway. Those perceived to need most therapy were more likely to follow the inpatient transfer pathway. Costs were lowest and mortality was highest for patients on the direct discharge pathway. ...Continue Reading

References

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Jun 27, 2018·BMJ : British Medical Journal·Nigel Hawkes

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Citations

May 2, 2020·The Cochrane Database of Systematic Reviews·Hezekiah StrattonLouisa Ng
Sep 7, 2018·Disability and Rehabilitation·Julie Pryor, Sandra Lever
Jun 2, 2020·Circulation. Cardiovascular Quality and Outcomes·Pamela W DuncanUNKNOWN COMPASS Site Investigators and Teams.

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