http://jaha.ahajournals.org/content/2/5/e000451.abstract
- Gregg C. Fonarow, MD⇑;
- Li Liang, PhD;
- Eric E. Smith, MD, MPH;
- Mathew J. Reeves, PhD;
- Jeffrey L. Saver, MD;
- Ying Xian, MD, PhD;
- Adrian F. Hernandez, MD, MHS;
- Eric D. Peterson, MD, MPH;
- Lee H. Schwamm, MD,
- GWTG‐Stroke Steering Committee & Investigators
+ Author Affiliations
- Correspondence to:
Gregg C. Fonarow, MD, Ahmanson‐UCLA Cardiomyopathy Center, UCLA Medical Center, 10833 LeConte Avenue, Room 47‐123 CHS, Los Angeles, CA 90095‐1679. E‐mail: gfonarow@mednet.ucla.edu
Abstract
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.
No comments:
Post a Comment