TY - JOUR
T1 - Stroke unit care in germany: The german stroke registers study group (ADSR)
AU - on behalf of the German Stroke Register Study Group (ADSR)
AU - Hillmann, Steffi
AU - Wiedmann, Silke
AU - Rücker, Viktoria
AU - Berger, Klaus
AU - Nabavi, Darius
AU - Bruder, Ingo
AU - Koennecke, Hans Christian
AU - Seidel, Günter
AU - Misselwitz, Björn
AU - Janssen, Alfred
AU - Burmeister, Christoph
AU - Matthis, Christine
AU - Busse, Otto
AU - Hermanek, Peter
AU - Heuschmann, P.
AU - Eßer, M.
AU - Rode, S.
AU - Hoffmann, B.
AU - Walter, Georg
AU - Hohnhold, R.
AU - Reihs, A.
AU - Kalic, M.
AU - Dienlin, S.
AU - Raspe, H.
AU - Kolominsky-Rabas, P.
AU - Dienlin, S.
AU - Eßer, M.
AU - Heuschmann, P.
AU - Reihs, A.
N1 - Publisher Copyright:
© 2017 The Author(s).
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2017/3/9
Y1 - 2017/3/9
N2 - Background: Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care. Methods: Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators. Results: In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago. Conclusions: Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low.
AB - Background: Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care. Methods: Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators. Results: In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago. Conclusions: Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low.
UR - http://www.scopus.com/inward/record.url?scp=85014756465&partnerID=8YFLogxK
U2 - 10.1186/s12883-017-0819-0
DO - 10.1186/s12883-017-0819-0
M3 - Journal articles
C2 - 28279162
AN - SCOPUS:85014756465
VL - 17
JO - BMC Neurology
JF - BMC Neurology
IS - 1
M1 - 49
ER -
