Regional Intervention of Stroke Care to Increase Thrombolytic Therapy for Acute Ischemic Stroke: The Southeast Texas Experience
Regional Intervention of Stroke Care to Increase Thrombolytic Therapy for Acute Ischemic Stroke: The Southeast Texas Experience
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DOI：
10.1161/strokeaha.118.021109
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发表时间：
2018-08-01
期刊：
影响因子：
8.3
通讯作者：
Suarez, Jose I.
中科院分区：
文献类型：
--
作者：
Damani, Rahul H.;Anand, Samyuktha;Suarez, Jose I.
背景和目的本研究的目的是调查干预对r-tPA（重组组织型纤溶酶原激活剂）给药的开放数据的影响，并与参与医院的首席执行官共享数据，干预后r-tPA给药率和26家东南德克萨斯地区咨询委员会医院实施的潜在医疗成本节约。方法回顾性分析2014年4月至2016年6月26家东南德克萨斯州地区咨询委员会医院溶栓治疗的前瞻性数据。对照（盲法）期（2014年第二季度至2015年第二季度）之后是解盲（2015年第三季度）。结果干预与r-tPA给药率增加21.1%相关，当门到针时间为60分钟时，r-tPA给药率增加38.5%。r-tPA使用绝对增加2.1%，平均终生成本节省360万美元。结论透明的区域数据共享与改善r-tPA管理和节省医疗成本有关。
Background and Purpose The aims of this study were to investigate the effect of an intervention to unblind data on r-tPA (recombinant tissue-type plasminogen activator) administration and sharing data with chief executive officers of participating hospitals, on r-tPA administration rates postintervention and on potential healthcare cost savings implemented at 26 Southeast Texas Regional Advisory Council hospitals.Methods Retrospective analysis of prospective data on thrombolytic therapy from 26 Southeast Texas Regional Advisory Council hospitals, collected between April 2014 and June 2016. The control (blinded) period (Q2-2014 to Q2-2015) was followed by unblinding (Q3-2015).Results Intervention was associated with 21.1% increase in r-tPA administration rates, with 38.5% increase in r-tPA administration with door-to-needle time 60 minutes. An absolute increase in r-tPA administration of 2.1% was seen with an average lifetime cost savings of $3.6 million.Conclusions Transparent regional data sharing was associated with improved r-tPA administration and healthcare cost savings.