Variation between hospitals in patient outcome after stroke is only partly explained by differences in quality of care: results from the Netherlands Stroke Survey

Journal of Neurology, Neurosurgery, and Psychiatry
H F LingsmaNetherlands Stroke Survey investigators

Abstract

Patient outcome is often used as an indicator of quality of hospital care. The aim of this study is to investigate whether there is a straightforward relationship between quality of care and outcome, and whether outcome measures could be used to assess quality of care after stroke. In 10 centres in The Netherlands, 579 patients with acute stroke were prospectively and consecutively enrolled. Poor outcome was defined as a score on the modified Rankin scale >or=3 at 1 year. Quality of care was assessed by relating diagnostic, therapeutic and preventive procedures to indication. Multiple logistic regression models were used to compare observed proportions of patients with poor outcome with expected proportions, after adjustment for patient characteristics and quality of care parameters. A total of 271 (47%) patients were dead or disabled at 1 year. Poor outcome varied across the centres from 29% to 78%. Large differences between centres were also observed in clinical characteristics, prognostic factors and quality of care. For example, between hospital quartiles based on outcome, age >or=70 years varied from 50% to 65%, presence of vascular risk factors from 88% to 96%, intravenous fluids when indicated from 35% to 81%, and antihy...Continue Reading

Citations

Dec 17, 2009·QJM : Monthly Journal of the Association of Physicians·H F LingsmaUNKNOWN Netherlands Stroke Survey Investigators
Mar 10, 2016·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Jennifer SchwartzIsuru Ranasinghe
Nov 6, 2010·International Journal of Stroke : Official Journal of the International Stroke Society·Julie A LukerKaren Grimmer-Somers
Jan 23, 2013·The British Journal of Surgery·A M van DishoeckH F Lingsma
Jun 26, 2010·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jolanda LammersKiki Lombarts
Jan 6, 2010·Acta Neurologica Scandinavica·H F LingsmaUNKNOWN Netherlands Stroke Survey Investigators
Jun 11, 2015·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Yu-Chi TungKuo-Piao Chung
Jun 13, 2015·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·C FischerE W Steyerberg
Jan 18, 2017·Circulation. Cardiovascular Quality and Outcomes·Janet Prvu BettgerEric D Peterson
Dec 24, 2008·Circulation·Diederik W J Dippel, Maarten L Simoons
Oct 8, 2011·Stroke; a Journal of Cerebral Circulation·Carol ParkerMathew J Reeves
Jan 9, 2010·Medical Care·Uzor C OgbuGert P Westert
Mar 14, 2012·Medical Care·Yvette R B M van GestelJan Willem W Coebergh
Jun 22, 2017·The Neurohospitalist·Eric E AdelmanLewis B Morgenstern
Nov 2, 2020·BMC Health Services Research·Marzyeh AminiUNKNOWN MR CLEAN Registry Investigators

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

© 2021 Meta ULC. All rights reserved