Variations in acute hospital stroke care and factors influencing adherence to quality indicators in 6 European audits

Stroke. 2015 Feb;46(2):579-81. doi: 10.1161/STROKEAHA.114.007504. Epub 2014 Dec 30.

Abstract

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.

Keywords: health services research; quality indicators, health care; quality of healthcare; stroke care.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Delivery of Health Care / standards*
  • Emergency Medical Services / standards*
  • Europe / epidemiology
  • Female
  • Guideline Adherence / standards*
  • Humans
  • Male
  • Medical Audit / standards*
  • Middle Aged
  • Quality Indicators, Health Care / standards*
  • Retrospective Studies
  • Sex Factors
  • Stroke / epidemiology
  • Stroke / therapy*