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Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke.
Song, Sarah; Fonarow, Gregg C; Olson, DaiWai M; Liang, Li; Schulte, Phillip J; Hernandez, Adrian F; Peterson, Eric D; Reeves, Mathew J; Smith, Eric E; Schwamm, Lee H; Saver, Jeffrey L.
Afiliação
  • Song S; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Fonarow GC; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Olson DM; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Liang L; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Schulte PJ; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Hernandez AF; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Peterson ED; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Reeves MJ; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Smith EE; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Schwamm LH; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
  • Saver JL; From the Department of Neurology, Rush University Medical Center, Chicago, IL (S.S.); Departments of Cardiology (G.C.F.) and Neurology (J.L.S.), University of California, Los Angeles; Department of Neurology, University of Texas-Southwestern, Dallas (D.M.O.); Departments of Biostatistics and Bioinfo
Stroke ; 47(5): 1294-302, 2016 05.
Article em En | MEDLINE | ID: mdl-27079809
ABSTRACT
BACKGROUND AND

PURPOSE:

Get With The Guidelines (GWTG)-Stroke is a national, hospital-based quality improvement program developed by the American Heart Association. Although studies have suggested improved processes of care in GWTG-Stroke-participating hospitals, it is not known whether this improved care translates into improved clinical outcomes compared with nonparticipating hospitals.

METHODS:

From all acute care US hospitals caring for Medicare beneficiaries with acute stroke between April 2003 and December 2008, we matched hospitals that joined the GWTG-Stroke program with similar hospitals that did not. Using a difference-in-differences design, we analyzed whether hospital participation in GWTG-Stroke was associated with a greater improvement in clinical outcomes compared with the underlying secular change.

RESULTS:

The matching algorithm identified 366 GWTG-Stroke-adopting hospitals that cared for 88 584 acute ischemic stroke admissions and 366 non-GWTG-Stroke hospitals that cared for 85 401 acute ischemic stroke admissions. Compared with the Pre period (18-6 months before program implementation), in the Early period (0-6 months after program implementation), GWTG-Stroke hospitals had accelerated increases in discharge to home and reduced mortality at 30 days and 1 year. In the Sustained period (6-18 months after program implementation), the accelerated reduction in mortality at 1 year was sustained, with a trend toward sustained accelerated increase in discharge home.

CONCLUSIONS:

Hospital adoption of the GWTG-Stroke program was associated with improved functional outcomes at discharge and reduced postdischarge mortality.
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Texto completo: 1 Coleções APS: Guias_protocolos_manuais_internacional Base de dados: MEDLINE Assunto principal: Avaliação de Processos e Resultados em Cuidados de Saúde / Isquemia Encefálica / Medicare / Acidente Vascular Cerebral / Melhoria de Qualidade / Hospitalização Limite: Aged / Aged80 / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2016
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções APS: Guias_protocolos_manuais_internacional Base de dados: MEDLINE Assunto principal: Avaliação de Processos e Resultados em Cuidados de Saúde / Isquemia Encefálica / Medicare / Acidente Vascular Cerebral / Melhoria de Qualidade / Hospitalização Limite: Aged / Aged80 / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2016