Objective: In developing a statewide system of stroke care, understanding the relative availability of acute stroke care at designated centers for stroke care is essential. In this article, we compare the change in availability of acute stroke care in North Carolina at Joint Commission Primary Stroke Centers (JCPSCs) between 2006 and 2008 by examining the drive-time proximity of the residential address to the nearest JCPSC among people who died of stroke.
Methods: We assigned geographic coordinates to residential addresses of North Carolinians who died of stroke and to addresses of North Carolina JCPSCs. We calculated the distance within a 40-minute drive from each JCPSC and determined whether the residential addresses of patients who died of stroke were in the areas demarcated by the drive time. In a secondary analysis, we included non-ICPSCs that participate in recognized quality-improvement programs for stroke care.
Results: In 2006, 37% of geocodable residences of patients who died of stroke (3,834 of 10,469) were within a 40-minute drive from a JCPSC. By the end of 2008, this percentage increased to 56% (3,482 of 6,204). Inclusion of other hospitals that participate in recognized quality-improvement programs for acute stroke care increased the 40-minute drive-time coverage to 82% (5,095 of 6,204).
Limitations: As an index of the geographic distribution of the stroke burden, we used deaths due to stroke, rather incident strokes. We included several assumptions in our drive-time calculation.
Conclusions: For many regions of North Carolina in which the stroke burden is high, timely care at JCPSCs for acute stroke is unavailable. To develop a statewide system for acute stroke care in North Carolina, criteria beyond JCPSC certification should be considered for designating hospitals as centers for stroke care.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
The feasibility of assessing prognosis over 3 years in persons with a previous stroke/transient ischemic attack in general practice.
Pilot Feasibility Stud
January 2025
School of Medicine, University of Limerick, Limerick, Ireland.
Background: Stroke has devastating consequences for survivors. Hypertension is the most important modifiable risk factor, and its management largely takes place in primary care. However, most stroke-based research does not occur in this setting.
View Article and Find Full Text PDFDifferences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden.
BMC Prim Care
January 2025
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Aims: To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC).
Methods: We used register data from Region Stockholm on collected prescribed medication and registered diagnoses, to identify patients aged 30 years and above with hypertension. Age-adjusted logistic regression was used to calculate odds ratios (ORs) with 99% confidence intervals (99% CIs) using public PHC centers as referents.
Safety outcome trials in four mainline medical journals 30 years apart: a narrative review and the need for the transparency of informed consents.
Trials
January 2025
Internal Medicine (Rheumatology), Academic Hospital, Istanbul, Turkey.
Background: It was our impression that safety outcome trials were getting more frequent, raising ethical issues mainly related to patient autonomy. We and others had also proposed this autonomy would be best served if wording of the informed consents would be in the public domain.
Methods: Initially two observers and an arbiter tabulated the main aims of randomized controlled trials (RCTs) published in 1990-1991 vs.
Volume-viscosity swallow test to facilitate individualized dietary modifications for dysphagia following intracerebral hemorrhage.
Eur Arch Otorhinolaryngol
January 2025
Geriatric Care Research Center, Xiamen Medical College, Xiamen, Fujian, 361023, China.
Purpose: This study examined the effects of individualized dietary modifications based on the volume-viscosity swallow test (V-VST) on functional oral intake, incidence of pneumonia, and swallowing-related quality of life in individuals with intracerebral hemorrhage.
Methods: One hundred and seven participants with signs of dysphagia in the acute and early subacute phases of stroke following intracerebral hemorrhage were randomly assigned into an experimental group for individualized dietary modifications based on V-VST plus routine standard care (n = 53), and a control group for routine care alone (n = 54). Incidence of pneumonia, functional oral intake scale (FOIS) ratings and Eating Assessment Tool (EAT-10) scores before and after intervention were evaluated.
Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland.
Lancet
January 2025
British Heart Foundation Centre of Research Excellence, University of Edinburgh, Edinburgh, UK; Edinburgh Imaging, University of Edinburgh, Edinburgh, UK.
Background: The Scottish Computed Tomography of the Heart (SCOT-HEART) trial demonstrated that management guided by coronary CT angiography (CCTA) improved the diagnosis, management, and outcome of patients with stable chest pain. We aimed to assess whether CCTA-guided care results in sustained long-term improvements in management and outcomes.
Methods: SCOT-HEART was an open-label, multicentre, parallel group trial for which patients were recruited from 12 outpatient cardiology chest pain clinics across Scotland.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!