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Influence of stroke coordinators on delivery of acute stroke care and hospital outcomes: An observational study.
- Source :
-
International journal of stroke : official journal of the International Stroke Society [Int J Stroke] 2018 Aug; Vol. 13 (6), pp. 585-591. Date of Electronic Publication: 2017 Nov 14. - Publication Year :
- 2018
-
Abstract
- Background Stroke coordinators have been inconsistently used in various countries to support stroke care in hospital. Aim To investigate the association between stroke coordinators and the provision of evidence-based care and patient outcomes in hospitals with acute stroke units. Methods Observational study using cross-sectional data from the 2015 National Acute Services Audit Program (Australia): including a retrospective medical record audit (40 records from each hospital) and a self-reported survey of organizational resources for stroke. Multilevel random effects logistic regression for patient outcomes including complications, independence on discharge, and death. Median regression for length of stay comparisons. Results A total of 109 hospitals submitted 4060 cases; 59 (54%) had a stroke coordinator. Compared with patients from stroke unit hospitals with no stroke coordinator ( N = 33, 1333 cases), patients in stroke unit hospitals with a stroke coordinator ( N = 53, 2072 cases) were more likely to receive clinical practices including rehabilitation therapy within 48 hours of initial assessment (88 vs. 82%, p < 0.001), risk factor modification advice (62 vs. 55%, p = 0.003) and receive a discharge care plan (65 vs. 48%, p < 0.001). No differences in complications, independence on discharge, or deaths were evident. Patients from hospitals with a stroke coordinator were more likely to access inpatient rehabilitation (adjusted odds ratio 1.8, 95% confidence interval 1.1-2.8) and have a reduced length of acute stay if discharged (median 14 h, p = 0.03). Conclusion Presence of stroke coordinators was associated with reduced length of stay and improved delivery of evidence-based care in hospitals with a stroke unit.
- Subjects :
- Aged
Australia epidemiology
Cross-Sectional Studies
Delivery of Health Care
Evidence-Based Practice
Female
Hospital Units
Hospitals
Humans
Male
Retrospective Studies
Risk Factors
Stroke mortality
Stroke therapy
Stroke Rehabilitation
Survival Analysis
Treatment Outcome
Length of Stay statistics & numerical data
Organization and Administration
Stroke epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1747-4949
- Volume :
- 13
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of stroke : official journal of the International Stroke Society
- Publication Type :
- Academic Journal
- Accession number :
- 29134926
- Full Text :
- https://doi.org/10.1177/1747493017741382