Stroke Center Certification and Performance: A Longitudinal Analysis of the Northeast Cerebrovascular Consortium Region.

Autor:	Wira CR 3rd; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT., Melluzzo S; American Stroke Association, Waltham, MA., Beasley TM; School of Public Health, University of Alabama at Birmingham, Birmingham, AL., Magdon-Ismail Z; American Stroke Association, Albany NY., Day D; American Stroke Association, Albany NY., Madsen TE; Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI., McCullough LD; Department of Neurology, University of Texas at Houston, Houston, TX., Stein J; Department of Physical Medicine and Rehabilitation, Columbia College of Physicians and Surgeons, New York, NY., Schwamm LH; Department of Neurology, Massachusetts General Hospital, Boston, MA., Gropen T; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.
Jazyk:	angličtina
Zdroj:	The Yale journal of biology and medicine [Yale J Biol Med] 2019 Dec 20; Vol. 92 (4), pp. 587-596. Date of Electronic Publication: 2019 Dec 20 (Print Publication: 2019).
Abstrakt:	Background : The NorthEast Cerebrovascular Consortium (NECC) was established in 2006 to improve stroke-systems-of-care models. Methods : This study evaluates the increase in stroke quality over time in NECC and Non-NECC regions, defined as the change in proportion of hospitals over time who received State or National Primary/Comprehensive Stroke Center (PSC/CSC) certification, participated in a national quality program (Get-With-The-Guidelines-Stroke (GWTG-S)), or received GWTG-S Performance Achievement Awards (PAA) from 2005-2013. Analysis of trends was performed (Cochran-Armitage/Cochran-Mantel-Haenszel tests; Generalized-Estimating Equations). As an exploratory analysis eight NECC region Departments of Health (DOH) were surveyed regarding perceptions of the NECC. Results : During the study period, there were 433.1 ± 10.2 vs 3986.4 ± 187.7 hospitals per year in the NECC vs non-NECC regions. Rate of growth per year increased in both groups for each measure but to a greater degree in the NECC vs Non-NECC regions: PSC/CSC (5.4%/yr vs 3.2%/yr), GWTG-S participation (5.0%/yr vs 2.9%/yr), and PAAs (5.2%/yr vs 2.1%/yr), with state-based certification growth also being higher in the NECC region (4.2%/yr vs 0.4%/yr; all comparisons p < 0.0001). After adjusting for year, significantly more NECC hospitals had PSC/CSC certification, GWTG-S participation, and GWTG-S PAAs than non-NECC sites (all analyses p < 0.0001). One hundred percent of NECC region DOHs were aware of the NECC and involved in functions, 87.5% indicated the NECC provided beneficial assistance. Conclusions : There has been a higher rate of growth of state certification contrasted to national PSC/CSC certification, and a higher rate of growth of participation and achievement in GWTG-S in the northeast region compared to other US regions. (Copyright ©2019, Yale Journal of Biology and Medicine.)
Databáze:	MEDLINE
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