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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)
Citation
Dwyer, M and Francis, K and Peterson, GM and Ford, K and Gall, S and Phan, H and Castley, H and Wong, L and White, R and Ryan, F and Arthurson, L and Kim, J and Cadilhac, DA and Lannin, NA, AuSCR Consortium, 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), BMJ Open pp. 1-8. ISSN 2044-6055 (2021) [Refereed Article]
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Copyright Statement
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
DOI: doi:10.1136/bmjopen-2020-040418
Abstract
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<0.001) or received treatment in stroke units (urban 82.2% vs rural 76.5%, p<0.001), and fewer were discharged with a care plan (urban 61.3% vs rural 44.7%, p<0.001). No ant differences were found in terms of survival or overall self-reported quality of life.
Item Details
Item Type: | Refereed Article |
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Keywords: | stroke, health services, rural health, equity, outcomes |
Research Division: | Health Sciences |
Research Group: | Health services and systems |
Research Field: | Health systems |
Objective Division: | Health |
Objective Group: | Clinical health |
Objective Field: | Treatment of human diseases and conditions |
UTAS Author: | Dwyer, M (Dr Mitchell Dwyer) |
UTAS Author: | Francis, K (Professor Karen Francis) |
UTAS Author: | Peterson, GM (Professor Gregory Peterson) |
UTAS Author: | Gall, S (Associate Professor Seana Gall) |
UTAS Author: | Phan, H (Dr Hoang Phan) |
ID Code: | 145000 |
Year Published: | 2021 |
Web of Science® Times Cited: | 4 |
Deposited By: | Menzies Institute for Medical Research |
Deposited On: | 2021-06-24 |
Last Modified: | 2021-09-08 |
Downloads: | 9 View Download Statistics |
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