- Title
- Quality of acute care and long-term quality of life and survival: the Australian Stroke Clinical Registry
- Creator
- Cadilhac, Dominique A.; Andrew, Nadine E.; Wong, Andrew; Sabet, Arman; Butler, Ernest; Bladin, Christopher F.; Bates, Timothy R.; Groot, Patrick; Castley, Helen; Donnan, Geoffrey A.; Anderson, Craig S.; Lannin, Natasha A.; Middleton, Sandy; Levi, Christopher R.; Dewey, Helen M.; Grabsch, Brenda; Faux, Steve; Hill, Kelvin; Grimley, Rohan
- Relation
- Funding BodyNHMRCGrant Number1043913 http://purl.org/au-research/grants/nhmrc/1043913
- Relation
- Stroke Vol. 48, Issue 4, p. 1026-1032
- Publisher Link
- http://dx.doi.org/10.1161/STROKEAHA.116.015714
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2017
- Description
- Background and Purpose: Uncertainty exists over whether quality improvement strategies translate into better health-related quality of life (HRQoL) and survival after acute stroke. We aimed to determine the association of best practice recommended interventions and outcomes after stroke. Methods: Data are from the Australian Stroke Clinical Registry during 2010 to 2014. Multivariable regression was used to determine associations between 3 interventions: received acute stroke unit (ASU) care and in various combinations with prescribed antihypertensive medication at discharge, provision of a discharge care plan, and outcomes of survival and HRQoL (EuroQoL 5-dimensional questionnaire visual analogue scale) at 180 days, by stroke type. An assessment was also made of outcomes related to the number of processes patients received. Results: There were 17 585 stroke admissions (median age 77 years, 47% female; 81% managed in ASUs; 80% ischemic stroke) from 42 hospitals (77% metropolitan) assessed. Cumulative benefits on outcomes related to the number of care processes received by patients. ASU care was associated with a reduced likelihood of death (hazard ratio, 0.49; 95% confidence interval, 0.43-0.56) and better HRQoL (coefficient, 21.34; 95% confidence interval, 15.50-27.18) within 180 days. For those discharged from hospital, receiving ASU+antihypertensive medication provided greater 180-day survival (hazard ratio, 0.45; 95% confidence interval, 0.38-0.52) compared with ASU care alone (hazard ratio, 0.64; 95% confidence interval, 0.54-0.76). HRQoL gains were greatest for patients with intracerebral hemorrhage who received care bundles involving discharge processes (range of increase, 11%-19%). Conclusions: Patients with stroke who receive best practice recommended hospital care have improved long-term survival and HRQoL.
- Subject
- hospitals; quality of health care; quality of life; stroke; survival
- Identifier
- http://hdl.handle.net/1959.13/1399322
- Identifier
- uon:34583
- Identifier
- ISSN:0039-2499
- Language
- eng
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