Variations in acute hospital stroke care and factors influencing adherence to quality indicators in 6 European audits.
BACKGROUND AND PURPOSE
We compared compliance with standards of acute stroke care between 6 European audits and identified factors associated with delivery of appropriate care.


METHODS
Data were derived from stroke audits in Germany, Poland, Scotland, Catalonia, Sweden, and England/Wales/Northern-Ireland participating within the European Implementation Score (EIS) collaboration. Associations between demographic and clinical characteristics with adherence to predefined quality indicators were investigated by hierarchical logistic regression analyses.


RESULTS
In 2007/2008 data from 329 122 patients with stroke were documented. Substantial variations in adherence to quality indicators were found; older age was associated with a lower probability of receiving thrombolytic therapy, anticoagulant therapy, or stroke unit treatment and a higher probability of being tested for dysphagia. Women were less likely to receive anticoagulant or antiplatelet therapy or stroke unit treatment. No major weekend effect was found.


CONCLUSIONS
Detected variations in performance of acute stroke services were found. Differences in adherence to quality indicators might indicate population subgroups with specific needs for improving care delivery.
['Wiedmann|Silke|S|', 'Hillmann|Steffi|S|', 'Abilleira|Sònia|S|', 'Dennis|Martin|M|', 'Hermanek|Peter|P|', 'Niewada|Maciej|M|', 'Norrving|Bo|B|', 'Asplund|Kjell|K|', 'Rudd|Anthony G|AG|', 'Wolfe|Charles D A|CD|', 'Heuschmann|Peter U|PU|', '|||']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D003695:Delivery of Health Care D004632:Emergency Medical Services D005060:Europe D005260:Female D019983:Guideline Adherence D006801:Humans D008297:Male D008485:Medical Audit D008875:Middle Aged D019984:Quality Indicators, Health Care D012189:Retrospective Studies D012737:Sex Factors D020521:Stroke
stroke care health services research quality indicators, health care quality of healthcare