Comparison of Performance Achievement Award Recognition With Primary Stroke Center Certification for Acute Ischemic Stroke Care

被引：17

作者：

Fonarow, Gregg C. ^{[1
]}

Liang, Li ^{[3
]}

Smith, Eric E. ^{[4
]}

Reeves, Mathew J. ^{[5
]}

Saver, Jeffrey L. ^{[2
]}

Xian, Ying ^{[3
]}

Hernandez, Adrian F. ^{[3
]}

Peterson, Eric D. ^{[3
]}

Schwamm, Lee H. ^{[6
]}

机构：

[1] Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA USA

[2] Univ Calif Los Angeles, Div Neurol, Los Angeles, CA USA

[3] Duke Clin Res Ctr, Durham, NC USA

[4] Univ Calgary, Hotchkiss Brain Inst, Dept Clin Neurosci, Calgary, AB, Canada

[5] Michigan State Univ, Dept Epidemiol, E Lansing, MI 48824 USA

[6] Massachusetts Gen Hosp, Div Neurol, Boston, MA 02114 USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2013年 / 2卷 / 05期

关键词：

acute stroke; measures registry; Primary Stroke Center certification; QUALITY-OF-CARE; GUIDELINES-STROKE; CARDIOVASCULAR-RADIOLOGY; ATTACK; ASSOCIATION; DISEASE; RECOMMENDATIONS; ESTABLISHMENT; INTERVENTION; STATEMENT;

D O I：

10.1161/JAHA.113.000451

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-Hospital certification and recognition programs represent 2 independent but commonly used systems to distinguish hospitals, yet they have not been directly compared. This study assessed acute ischemic stroke quality of care measure conformity by hospitals receiving Primary Stroke Center (PSC) certification and those receiving the American Heart Association's Get With The Guidelines-Stroke (GWTG-Stroke) Performance Achievement Award (PAA) recognition. Methods and Results-The patient and hospital characteristics as well as performance/quality measures for acute ischemic stroke from 1356 hospitals participating in the GWTG-Stroke Program 2010-2012 were compared. Hospitals were classified as PAA+/PSC+ (hospitals n=410, patients n=169 302), PAA+/PSC- (n=415, n=129 454), PAA-/PSC+ (n=88, n=26 386), and PAA-/PSC- (n=443, n=75 565). A comprehensive set of stroke measures were compared with adjustment for patient and hospital characteristics. Patient characteristics were similar by PAA and PSC status but PAA-/PSC- hospitals were more likely to be smaller and nonteaching. Measure conformity was highest for PAA+/PSC+ and PAA+/PSC- hospitals, intermediate for PAA-/PSC+ hospitals, and lowest for PAA-/PSC- hospitals (all-or-none care measure 91.2%, 91.2%, 84.3%, and 76.9%, respectively). After adjustment for patient and hospital characteristics, PAA+/PSC+, PAA+/PSC-, and PAA-/PSC+ hospitals had 3.15 (95% CIs 2.86 to 3.47); 3.23 (2.93 to 3.56) and 1.72 (1.47 to 2.00), higher odds for providing all indicated stroke performance measures to patients compared with PAA-/PSC- hospitals. Conclusions-While both PSC certification and GWTG-Stroke PAA recognition identified hospitals providing higher conformity with care measures for patients hospitalized with acute ischemic stroke, PAA recognition was a more robust identifier of hospitals with better performance.

引用

页数：12

共 27 条

[1] Guidelines for the early management of adults with ischemic stroke - A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups [J].

Adams, Harold P., Jr. ;

del Zoppo, Gregory ;

Alberts, Mark J. ;

Bhatt, Deepak L. ;

Brass, Lawrence ;

Furlan, Anthony ;

Grubb, Robert L. ;

Higashida, Randall T. ;

Jauch, Edward C. ;

Kidwell, Chelsea ;

Lyden, Patrick D. ;

Morgenstern, Lewis B. ;

Qureshi, Adnan I. ;

Rosenwasser, Robert H. ;

Scott, Phillip A. ;

Wijdicks, Eelco F. M. .

STROKE, 2007, 38 (05) :1655-1711

[2] Revised and Updated Recommendations for the Establishment of Primary Stroke Centers A Summary Statement From the Brain Attack Coalition [J].

Alberts, Mark J. ;

Latchaw, Richard E. ;

Jagoda, Andy ;

Wechsler, Lawrence R. ;

Crocco, Todd ;

George, Mary G. ;

Connolly, E. S. ;

Mancini, Barbara ;

Prudhomme, Stephen ;

Gress, Daryl ;

Jensen, Mary E. ;

Bass, Robert ;

Ruff, Robert ;

Foell, Kathy ;

Armonda, Rocco A. ;

Emr, Marian ;

Warren, Margo ;

Baranski, Jim ;

Walker, Michael D. .

STROKE, 2011, 42 (09) :2651-2665

[3] Recommendations for the establishment of primary stroke centers [J].

Alberts, MJ ;

Hademenos, G ;

Latchaw, RE ;

Jagoda, A ;

Marler, JR ;

Mayberg, MR ;

Starke, RD ;

Todd, HW ;

Viste, KM ;

Girgus, M ;

Shephard, T ;

Emr, M ;

Shwayder, P ;

Walker, MD .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 283 (23) :3102-3109

[4]

American Hospital Association, 2010, AM HOSP ASS HOSP STA

[5] Do the Brain Attack Coalition's criteria for stroke centers improve care for ischemic stroke? [J].

Douglas, VC ;

Tong, DC ;

Gillum, LA ;

Zhao, S ;

Brass, LM ;

Dostal, J ;

Johnston, SC .

NEUROLOGY, 2005, 64 (03) :422-427

[6] Hospital Certification for Optimizing Cardiovascular Disease and Stroke Quality of Care and Outcomes [J].

Fonarow, Gregg C. ;

Gregory, Tammy ;

Driskill, Meagen ;

Stewart, Mark D. ;

Beam, Craig ;

Butler, Javed ;

Jacobs, Alice K. ;

Meltzer, Neil M. ;

Peterson, Eric D. ;

Schwamm, Lee H. ;

Spertus, John A. ;

Yancy, Clyde W. ;

Tomaselli, Gordon F. ;

Sacco, Ralph L. .

CIRCULATION, 2010, 122 (23) :2459-2469

[7] Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke [J].

Fonarow, Gregg C. ;

Reeves, Mathew J. ;

Smith, Eric E. ;

Saver, Jeffrey L. ;

Zhao, Xin ;

Olson, Dai Wai ;

Hernandez, Adrian F. ;

Peterson, Eric D. ;

Schwamm, Lee H. .

CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2010, 3 (03) :291-U122

[8] Heart Disease and Stroke Statistics-2013 Update A Report From the American Heart Association [J].

Go, Alan S. ;

Mozaffarian, Dariush ;

Roger, Veronique L. ;

Benjamin, Emelia J. ;

Berry, Jarett D. ;

Borden, William B. ;

Bravata, Dawn M. ;

Dai, Shifan ;

Ford, Earl S. ;

Fox, Caroline S. ;

Franco, Sheila ;

Fullerton, Heather J. ;

Gillespie, Cathleen ;

Hailpern, Susan M. ;

Heit, John A. ;

Howard, Virginia J. ;

Huffman, Mark D. ;

Kissela, Brett M. ;

Kittner, Steven J. ;

Lackland, Daniel T. ;

Lichtman, Judith H. ;

Lisabeth, Lynda D. ;

Magid, David ;

Marcus, Gregory M. ;

Marelli, Ariane ;

Matchar, David B. ;

McGuire, Darren K. ;

Mohler, Emile R. ;

Moy, Claudia S. ;

Mussolino, Michael E. ;

Nichol, Graham ;

Paynter, Nina P. ;

Schreiner, Pamela J. ;

Sorlie, Paul D. ;

Stein, Joel ;

Turan, Tanya N. ;

Virani, Salim S. ;

Wong, Nathan D. ;

Woo, Daniel ;

Turner, Melanie B. .

CIRCULATION, 2013, 127 (01) :E6-E245

[9] Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure [J].

Heidenreich, Paul A. ;

Lewis, William R. ;

LaBresh, Kenneth A. ;

Schwamm, Lee H. ;

Fonarow, Gregg C. .

AMERICAN HEART JOURNAL, 2009, 158 (04) :546-553

[10] Benchmarks and determinants of adherence to stroke performance measures [J].

Hinchey, Judith A. ;

Shephard, Timothy ;

Tonn, Sarah T. ;

Ruthazer, Robin ;

Selker, Harry P. ;

Kent, David M. .

STROKE, 2008, 39 (05) :1619-1620

← 1 2 3 →