Moving Toward Equity in Intracerebral Hemorrhage Care

More stupidity, measuring processes rather than results. Who gives a shit if a hospital does Get With The Guidelines ok? Survivors want to know if end results are better. Fewer 30-day deaths, more survivors that get to 100% recovery.  All these people would be fired working for me.
http://stroke.ahajournals.org/content/45/11/3178.full

1. Lewis B. Morgenstern, MD

+ Author Affiliations

1. From the Stroke Program and Department of Epidemiology, The University of Michigan Medical School and School of Public Health, Ann Arbor.

1. Correspondence to Lewis B. Morgenstern, MD, University of Michigan Cardiovascular Center, Room 3194, 1500 East Medical Center Dr, Ann Arbor, MI 48109. E-mail Lmorgens@umich.edu

Key Words:

• Editorials
• intracerebral hemorrhage
• race
• stroke

See related article, p 3243.

In 2003, the Institute of Medicine published Unequal Treatment, a groundbreaking indictment of bias and discrimination in medical care in the United States.¹ In addition to the copious data documenting race/ethnic health disparities and the deleterious effects of overt and perceived discrimination, the Institute of Medicine set forth several suggestions to remedy this unconscionable state of affairs. Among these were the use of quality measures and organized means to deliver high quality medical care to all patients regardless of race, ethnicity, or socioeconomic status. In the United States, The Joint Commission’s certification of primary and comprehensive stroke centers seeks to promote this evidence-based approach to providing consistent, high quality medical care to all patients.

In the present issue of Stroke, Xian et al² use the remarkably comprehensive Get with the Guidelines (GWTG) database to answer questions about the association of race/ethnicity, quality measures, and intracerebral hemorrhage (ICH) outcome in the United States. The article suggests that minority populations (African Americans, Hispanics, and Asian Americans) are cared for with at least the same, if not better, quality and have decreased in-hospital mortality, despite worse initial stroke severity compared with non-Hispanic whites. This is all welcome news in a country where stroke disparities are well documented.³ But should we celebrate this as a victory? 

Full text at link.