Sökning: WFRF:(Glader Eva Lotta 1972 ) >
Diurnal variations ...
Diurnal variations in the quality of stroke care in Sweden
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- Darehed, David (författare)
- Umeå University,Sunderby Research Unit,University College London
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- Blom, Mathias (författare)
- Lund University,Lunds universitet,Medicin/akutsjukvård, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Glader, Eva-Lotta, 1972- (författare)
- Umeå universitet,Umeå University,Avdelningen för medicin
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- Niklasson, Johan (författare)
- Umeå universitet,Umeå University,Geriatrik
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- Norrving, Bo (författare)
- Lund University,Lunds universitet,Stroke policy och kvalitetsregisterforskning,Forskargrupper vid Lunds universitet,Stroke policy and quality register research,Lund University Research Groups
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- Bray, Benjamin D. (författare)
- University College London
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- Eriksson, Marie, Professor (författare)
- Umeå universitet,Umeå University,Statistik
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(creator_code:org_t)
- 2019-05-14
- 2019
- Engelska.
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 140:2, s. 123-130
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Objectives: A recent study of acute stroke patients in England and Wales revealed several patterns of temporal variation in quality of care. We hypothesized that similar patterns would be present in Sweden and aimed to describe these patterns. Additionally, we aimed to investigate whether hospital type conferred resilience against temporal variation. Materials and Methods: We conducted this nationwide registry-based study using data from the Swedish Stroke Register (Riksstroke) including all adult patients registered with acute stroke between 2011 and 2015. Outcomes included process measures and survival. We modeled time of presentation as on/off-hours, shifts, day of week, 4-hour, and 12-hour time blocks. We studied hospital resilience by comparing outcomes across hospital types. Results: A total of 113 862 stroke events in 72 hospitals were included. The process indicators and survival all showed significant temporal variation. Door-to-needle (DTN) time within 30 minutes was less likely during nighttime than daytime (OR 0.50; 95% CI 0.41-0.60). Patients admitted during off-hours had lower odds of direct stroke unit (SU) admission (OR 0.72; 95% CI 0.70-0.75). 30-day survival was lower in nighttime vs daytime presentations (OR 0.90, 95% CI 0.84-0.96). The effects of temporal variation differed significantly between hospital types for DTN time within 30 minutes and direct SU admission where university hospitals were more resilient than specialized non-university hospitals. Conclusions: Our study shows that variation in quality of care and survival is present throughout the whole week. We also found that university hospitals were more resilient to temporal variation than specialized non-university hospitals.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Nyckelord
- off-hours
- quality of care
- stroke
- temporal variation
- weekend effect
- weekly variation
- Off hours
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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