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Stroke unit care in Germany: the German stroke registers study group (ADSR)

Please always quote using this URN: urn:nbn:de:bvb:20-opus-159447
  • 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.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.show moreshow less

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Metadaten
Author: Steffi Hillmann, Silke Wiedmann, Viktoria Rücker, Klaus Berger, Darius Nabavi, Ingo Bruder, Hans-Christian Koennecke, Günter Seidel, Björn Misselwitz, Alfred Janssen, Christoph Burmeister, Christine Matthis, Otto Busse, Peter Hermanek, Peter Ulrich Heuschmann
URN:urn:nbn:de:bvb:20-opus-159447
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für Klinische Epidemiologie und Biometrie
Language:English
Parent Title (English):BMC Neurology
Year of Completion:2017
Volume:17
Issue:49
Source:BMC Neurology (2017) 17:49. DOI: 10.1186/s12883-017-0819-0
DOI:https://doi.org/10.1186/s12883-017-0819-0
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 616 Krankheiten
Tag:quality indicators; quality of health care; stroke register; stroke unit care
Release Date:2018/03/28
Contributing Corporation:German Stroke Register Study Group (ADSR)
EU-Project number / Contract (GA) number:223153
OpenAIRE:OpenAIRE
Collections:Open-Access-Publikationsfonds / Förderzeitraum 2017
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International