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Multicenter comparison of processes of care between stroke units and conventional care wards in Australia


Cadilhac, DA and Ibrahim, J and Pearce, DC and Ogden, K and McNeill, J and Davis, SM and Donnan, GA, Multicenter comparison of processes of care between stroke units and conventional care wards in Australia, Stroke: A Journal of Cerebral Circulation, 35, (5) pp. 1035-1040. ISSN 0039-2499 (2004) [Refereed Article]

Copyright Statement

Copyright 2004 American Heart Association, Inc.

DOI: doi:10.1161/01.STR.0000125709.17337.5d


BACKGROUND AND PURPOSE: Approximately 23% of Australian hospitals provide Stroke Units (SUs). Evidence suggests that clinical outcomes are better in SUs than with conventional care. Reasons may include greater adherence to processes of care (PoC). The primary hypothesis was that adherence to selected PoC is greater in SUs than in other acute care models.

METHODS: Prospective, multicenter, single-blinded design. Models of care investigated: SUs, mobile services, and conventional care. Selected PoC were related to care models and participant outcomes. Data were collected at acute hospitalization (median 9 days) and at medians of 8 and 28 weeks after stroke.

RESULTS: 1701 patients were screened from 8 hospitals, 823 were eligible, and 468 participated. Response rate was 96% at final follow-up. Mean age was 73 years (SD 14). Overall PoC adherence rates for individual care models were SU 75%, mobile service 65%, and conventional care 52% (P<0.001). The adjusted odds of participants being alive at discharge if adhering to all or all but 1 PoC was significant (aOR 3.63; 95% CI: 1.04 to 12.66; P=0.043). Important trends at 28 weeks were found for being at home (aOR 3.09; 95% CI: 0.96 to 9.87; P=0.058) and independent (aOR 2.61; 95% CI: 0.96 to 7.10; P=0.061), with complete PoC adherence.

CONCLUSIONS: Adherence to key PoC was higher in SUs than in other models. For all patients, adherence to PoC was associated with improved mortality at discharge and trends found with independence at home, providing support for the need to increase access to stroke units.

Item Details

Item Type:Refereed Article
Keywords:Stroke, Stroke unit, processes of care
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Ogden, K (Dr Kathryn Ogden)
ID Code:95002
Year Published:2004
Web of Science® Times Cited:82
Deposited By:Medicine
Deposited On:2014-09-22
Last Modified:2014-11-17

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