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Regional differences in the care and outcomes of acute stroke patients in Australia: an observational study using evidence from the Australian Stroke Clinical Registry (AuSCR)

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Dwyer, M, Francis, K ORCID: 0000-0003-3578-2498, Peterson, GM ORCID: 0000-0002-6764-3882, Ford, K, Gall, S ORCID: 0000-0002-5138-2526, Phan, H ORCID: 0000-0003-0506-2924, Castley, H, Wong, L, White, R, Ryan, F, Arthurson, L, Kim, J, Cadilhac, DA and Lannin, NA 2021 , 'Regional differences in the care and outcomes of acute stroke patients in Australia: an observational study using evidence from the Australian Stroke Clinical Registry (AuSCR)' , BMJ Open, vol. 11, no. 4 , pp. 1-8 , doi: 10.1136/bmjopen-2020-040418.

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Abstract

Objective: To compare the processes and outcomes of care in patients who had a stroke treated in urban versus rural hospitals in Australia.Design: Observational study using data from a multicentre national registry.Setting: Data from 50 acute care hospitals in Australia (25 urban, 25 rural) which participated in the Australian Stroke Clinical Registry during the period 2010-2015.Participants: Patients were divided into two groups (urban, rural) according to the Australian Standard Geographical Classification Remoteness Area classification. Data pertaining to 28 115 patients who had a stroke were analysed, of whom 8159 (29%) were admitted to hospitals located within rural areas.Primary and secondary outcome measures: Regional differences in processes of care (admission to a stroke unit, thrombolysis for ischaemic stroke, discharge on antihypertensive medication and provision of a care plan), and survival analyses up to 180 days and health-related quality of life at 90-180 days.Results: Compared with those admitted to urban hospitals, patients in rural hospitals less often received thrombolysis (urban 12.7% vs rural 7.5%, pConclusions: Rural access to recommended components of acute stroke care was comparatively poorer; however, this did not appear to impact health outcomes at approximately 6 months.

Item Type: Article
Authors/Creators:Dwyer, M and Francis, K and Peterson, GM and Ford, K and Gall, S and Phan, H and Castley, H and Wong, L and White, R and Ryan, F and Arthurson, L and Kim, J and Cadilhac, DA and Lannin, NA
Keywords: accident & emergency medicine, organisation of health services, quality in health care, stroke medicine
Journal or Publication Title: BMJ Open
Publisher: BMJ Publishing Group Ltd.
ISSN: 2044-6055
DOI / ID Number: 10.1136/bmjopen-2020-040418
Copyright Information:

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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