Regional variation in acute stroke care organisation

Paula Muñoz Venturelli, Thompson Robinson, Pablo M. Lavados, Verónica V. Olavarría, Hisatomi Arima, Laurent Billot, Maree L. Hackett, Joyce Y. Lim, Sandy Middleton, Octavio Pontes-Neto, Bin Peng, Liying Cui, Lily Song, Gillian Mead, Caroline Watkins, Ruey Tay Lin, Tsong Hai Lee, Jeyaraj Pandian, H. Asita de Silva, Craig S. Anderson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background Few studies have assessed regional variation in the organisation of stroke services, particularly health care resourcing, presence of protocols and discharge planning. Our aim was to compare stroke care organisation within middle- (MIC) and high-income country (HIC) hospitals participating in the Head Position in Stroke Trial (HeadPoST). Methods HeadPoST is an on-going international multicenter crossover cluster-randomized trial of ‘sitting-up’ versus ‘lying-flat’ head positioning in acute stroke. As part of the start-up phase, one stroke care organisation questionnaire was completed at each hospital. The World Bank gross national income per capita criteria were used for classification. Results 94 hospitals from 9 countries completed the questionnaire, 51 corresponding to MIC and 43 to HIC. Most participating hospitals had a dedicated stroke care unit/ward, with access to diagnostic services and expert stroke physicians, and offering intravenous thrombolysis. There was no difference for the presence of a dedicated multidisciplinary stroke team, although greater access to a broad spectrum of rehabilitation therapists in HIC compared to MIC hospitals was observed. Significantly more patients arrived within a 4-h window of symptoms onset in HIC hospitals (41 vs. 13%; P 

Original languageEnglish
Pages (from-to)126-130
Number of pages5
JournalJournal of the Neurological Sciences
Volume371
Early online date18 Oct 2016
DOIs
Publication statusPublished - 15 Dec 2016

Keywords

  • Acute ischemic stroke
  • In- and out-hospital stroke care organisation
  • Intracerebral hemorrhage
  • Stroke
  • Stroke care
  • Thrombolysis

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