Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization
Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization
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DOI：
10.1161/strokeaha.116.014426
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发表时间：
2017-02-01
期刊：
影响因子：
8.3
通讯作者：
Fonarow, Gregg C.
中科院分区：
文献类型：
--
作者：
Man, Shumei;Cox, Margueritte;Fonarow, Gregg C.
背景和目的：初级卒中中心（PSC）认证的建立是为了确定为卒中患者提供循证护理的医院。在过去的十年中，由联合委员会（JC）、医疗保健设施认证计划、挪威船级社和国家机构认证的PSC数量显著增加。本研究旨在评估是否PSC认证的不同组织有类似的质量的护理和在医院outcome.Methods的研究人群包括急性缺血性中风患者谁被接纳到PSC参与获得与指南，中风2010年1月1日至2012年12月31日。4个不同的PSC certification.Results之间的护理质量和结果的措施进行了比较，共477297急性缺血性中风入院确定从977个认证的PSC（73.8% JC，3.7%挪威船级社，1.2%医疗机构认证计划，21.3%国家为基础）。4组医院的综合护理质量基本相似，尽管州立PSC在一些关键指标（包括静脉注射组织型纤溶酶原激活剂的使用）上表现低于JC PSC。JC和Det Norske Veritas的组织型纤溶酶原激活剂使用率较高（9.0%和9.8%），而国家和医疗机构认证计划认证的医院较低（7.1%和5.9%）（P
Background and Purpose Primary stroke center (PSC) certification was established to identify hospitals providing evidence-based care for stroke patients. The numbers of PSCs certified by Joint Commission (JC), Healthcare Facilities Accreditation Program, Det Norske Veritas, and State-based agencies have significantly increased in the past decade. This study aimed to evaluate whether PSCs certified by different organizations have similar quality of care and in-hospital outcomes.Methods The study population consisted of acute ischemic stroke patients who were admitted to PSCs participating in Get With The Guidelines-Stroke between January 1, 2010, and December 31, 2012. Measures of care quality and outcomes were compared among the 4 different PSC certifications.Results A total of 477297 acute ischemic stroke admissions were identified from 977 certified PSCs (73.8% JC, 3.7% Det Norske Veritas, 1.2% Healthcare Facilities Accreditation Program, and 21.3% State-based). Composite care quality was generally similar among the 4 groups of hospitals, although State-based PSCs underperformed JC PSCs in a few key measures, including intravenous tissue-type plasminogen activator use. The rates of tissue-type plasminogen activator use were higher in JC and Det Norske Veritas (9.0% and 9.8%) and lower in State and Healthcare Facilities Accreditation Program certified hospitals (7.1% and 5.9%) (P