Multicenter comparison of processes of care between Stroke Units and conventional care wards in Australia
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...
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| Veröffentlicht in: | Stroke (1970) 2004-05, Vol.35 (5), p.1035-1040 |
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| container_title | Stroke (1970) |
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| creator | CADILHAC, Dominique A IBRAHIM, Joeseph PEARCE, Dora C OGDEN, Kathryn J MCNEILL, John DAVIS, Stephen M DONNAN, Geoffrey A |
| description | 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.
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.
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 |
| doi_str_mv | 10.1161/01.STR.0000125709.17337.5d |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000125709.17337.5d</identifier><identifier>PMID: 15060326</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Australia - epidemiology ; Biological and medical sciences ; Cause of Death ; Female ; Health Services Accessibility - standards ; Hospital Units - organization & administration ; Humans ; Male ; Medical sciences ; Neurology ; Outcome and Process Assessment (Health Care) ; Patient Care Team - organization & administration ; Patients' Rooms - organization & administration ; Prospective Studies ; Quality of Health Care ; Single-Blind Method ; Stroke - epidemiology ; Stroke - mortality ; Stroke - therapy ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2004-05, Vol.35 (5), p.1035-1040</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c433t-d5b04608c81dd96fae68619a96fd105d48c5d74ebf521447a5f63225fd95052e3</citedby><cites>FETCH-LOGICAL-c433t-d5b04608c81dd96fae68619a96fd105d48c5d74ebf521447a5f63225fd95052e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,3676,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15723972$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15060326$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CADILHAC, Dominique A</creatorcontrib><creatorcontrib>IBRAHIM, Joeseph</creatorcontrib><creatorcontrib>PEARCE, Dora C</creatorcontrib><creatorcontrib>OGDEN, Kathryn J</creatorcontrib><creatorcontrib>MCNEILL, John</creatorcontrib><creatorcontrib>DAVIS, Stephen M</creatorcontrib><creatorcontrib>DONNAN, Geoffrey A</creatorcontrib><creatorcontrib>SCOPES Study Group</creatorcontrib><title>Multicenter comparison of processes of care between Stroke Units and conventional care wards in Australia</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>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.
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.
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.
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.</description><subject>Aged</subject><subject>Australia - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Cause of Death</subject><subject>Female</subject><subject>Health Services Accessibility - standards</subject><subject>Hospital Units - organization & administration</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurology</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Patient Care Team - organization & administration</subject><subject>Patients' Rooms - organization & administration</subject><subject>Prospective Studies</subject><subject>Quality of Health Care</subject><subject>Single-Blind Method</subject><subject>Stroke - epidemiology</subject><subject>Stroke - mortality</subject><subject>Stroke - therapy</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkF1LHTEQhkOp1FP1L5RQaO92m-_NeidSW0ER_LgOOckspN2TPWZ2lf57o-eADYRM4HlnhoeQr5y1nBv-g_H27v62ZfVwoTvWt7yTsmt1_EBWXAvVKCPsR7JiTPaNUH1_SD4j_qm8kFZ_IodcM8OkMCuSrpdxTgHyDIWGabP1JeGU6TTQbZkCIAK-foIvQNcwPwNkejeX6S_Qh5xmpD7HGsxPtUWash936LMvEWnK9GzBufgx-WNyMPgR4WT_HpGHi5_357-bq5tfl-dnV01QUs5N1GumDLPB8hh7M3gw1vDe1zJypqOyQcdOwXrQgivVeT0YKYQeYq-ZFiCPyPdd37r_4wI4u03CAOPoM0wLuo5bo601FTzdgaFMiAUGty1p48s_x5l7Fe0Yd1W0exft3kQ7HWv4y37Kst5AfI_uzVbg2x7wGPw4FJ9Dwv-4Tsi-3hfThIhI</recordid><startdate>20040501</startdate><enddate>20040501</enddate><creator>CADILHAC, Dominique A</creator><creator>IBRAHIM, Joeseph</creator><creator>PEARCE, Dora C</creator><creator>OGDEN, Kathryn J</creator><creator>MCNEILL, John</creator><creator>DAVIS, Stephen M</creator><creator>DONNAN, Geoffrey A</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040501</creationdate><title>Multicenter comparison of processes of care between Stroke Units and conventional care wards in Australia</title><author>CADILHAC, Dominique A ; IBRAHIM, Joeseph ; PEARCE, Dora C ; OGDEN, Kathryn J ; MCNEILL, John ; DAVIS, Stephen M ; DONNAN, Geoffrey A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c433t-d5b04608c81dd96fae68619a96fd105d48c5d74ebf521447a5f63225fd95052e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Australia - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Cause of Death</topic><topic>Female</topic><topic>Health Services Accessibility - standards</topic><topic>Hospital Units - organization & administration</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Patient Care Team - organization & administration</topic><topic>Patients' Rooms - organization & administration</topic><topic>Prospective Studies</topic><topic>Quality of Health Care</topic><topic>Single-Blind Method</topic><topic>Stroke - epidemiology</topic><topic>Stroke - mortality</topic><topic>Stroke - therapy</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CADILHAC, Dominique A</creatorcontrib><creatorcontrib>IBRAHIM, Joeseph</creatorcontrib><creatorcontrib>PEARCE, Dora C</creatorcontrib><creatorcontrib>OGDEN, Kathryn J</creatorcontrib><creatorcontrib>MCNEILL, John</creatorcontrib><creatorcontrib>DAVIS, Stephen M</creatorcontrib><creatorcontrib>DONNAN, Geoffrey A</creatorcontrib><creatorcontrib>SCOPES Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CADILHAC, Dominique A</au><au>IBRAHIM, Joeseph</au><au>PEARCE, Dora C</au><au>OGDEN, Kathryn J</au><au>MCNEILL, John</au><au>DAVIS, Stephen M</au><au>DONNAN, Geoffrey A</au><aucorp>SCOPES Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicenter comparison of processes of care between Stroke Units and conventional care wards in Australia</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2004-05-01</date><risdate>2004</risdate><volume>35</volume><issue>5</issue><spage>1035</spage><epage>1040</epage><pages>1035-1040</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>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.
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.
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.
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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>15060326</pmid><doi>10.1161/01.STR.0000125709.17337.5d</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Ovid Autoload; Alma/SFX Local Collection |
| subjects | Aged Australia - epidemiology Biological and medical sciences Cause of Death Female Health Services Accessibility - standards Hospital Units - organization & administration Humans Male Medical sciences Neurology Outcome and Process Assessment (Health Care) Patient Care Team - organization & administration Patients' Rooms - organization & administration Prospective Studies Quality of Health Care Single-Blind Method Stroke - epidemiology Stroke - mortality Stroke - therapy Vascular diseases and vascular malformations of the nervous system |
| title | Multicenter comparison of processes of care between Stroke Units and conventional care wards in Australia |
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