Regional differences in the care and outcomes of acute stroke patients in Australia: an observational study using evidence from the Australian Stroke Clinical Registry (AuSCR)

Autor: Joosup Kim, Dominique A Cadilhac, Richard White, Natasha A Lannin, Fiona Ryan, Karen Ford, Mitchell Dwyer, Karen Francis, Gregory M Peterson, Seana Gall, Hoang Phan, Helen Castley, Lillian Wong, Lauren Arthurson
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMJ Open, Vol 11, Iss 4 (2021)
Druh dokumentu: article
ISSN: 2020-0404
2044-6055
DOI: 10.1136/bmjopen-2020-040418
Popis: Objective To compare the processes and outcomes of care in patients who had a stroke treated in urban versus rural hospitals in Australia.Design Observational study using data from a multicentre national registry.Setting Data from 50 acute care hospitals in Australia (25 urban, 25 rural) which participated in the Australian Stroke Clinical Registry during the period 2010–2015.Participants Patients were divided into two groups (urban, rural) according to the Australian Standard Geographical Classification Remoteness Area classification. Data pertaining to 28 115 patients who had a stroke were analysed, of whom 8159 (29%) were admitted to hospitals located within rural areas.Primary and secondary outcome measures Regional differences in processes of care (admission to a stroke unit, thrombolysis for ischaemic stroke, discharge on antihypertensive medication and provision of a care plan), and survival analyses up to 180 days and health-related quality of life at 90–180 days.Results Compared with those admitted to urban hospitals, patients in rural hospitals less often received thrombolysis (urban 12.7% vs rural 7.5%, p
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