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Comparison of performance achievement award recognition with primary stroke center certification for acute ischemic stroke care.

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Date
2013-10-14
Authors
Fonarow, Gregg C
Liang, Li
Smith, Eric E
Reeves, Mathew J
Saver, Jeffrey L
Xian, Ying
Hernandez, Adrian F
Peterson, Eric D
Schwamm, Lee H
GWTG-Stroke Steering Committee & Investigators
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Abstract
BACKGROUND: Hospital certification and recognition programs represent 2 independent but commonly used systems to distinguish hospitals, yet they have not been directly compared. This study assessed acute ischemic stroke quality of care measure conformity by hospitals receiving Primary Stroke Center (PSC) certification and those receiving the American Heart Association's Get With The Guidelines-Stroke (GWTG-Stroke) Performance Achievement Award (PAA) recognition. METHODS AND RESULTS: The patient and hospital characteristics as well as performance/quality measures for acute ischemic stroke from 1356 hospitals participating in the GWTG-Stroke Program 2010-2012 were compared. Hospitals were classified as PAA+/PSC+ (hospitals n = 410, patients n = 169,302), PAA+/PSC- (n = 415, n = 129,454), PAA-/PSC+ (n = 88, n = 26,386), and PAA-/PSC- (n = 443, n = 75,565). A comprehensive set of stroke measures were compared with adjustment for patient and hospital characteristics. Patient characteristics were similar by PAA and PSC status but PAA-/PSC- hospitals were more likely to be smaller and nonteaching. Measure conformity was highest for PAA+/PSC+ and PAA+/PSC- hospitals, intermediate for PAA-/PSC+ hospitals, and lowest for PAA-/PSC- hospitals (all-or-none care measure 91.2%, 91.2%, 84.3%, and 76.9%, respectively). After adjustment for patient and hospital characteristics, PAA+/PSC+, PAA+/PSC-, and PAA-/PSC+ hospitals had 3.15 (95% CIs 2.86 to 3.47); 3.23 (2.93 to 3.56) and 1.72 (1.47 to 2.00), higher odds for providing all indicated stroke performance measures to patients compared with PAA-/PSC- hospitals. CONCLUSIONS: While both PSC certification and GWTG-Stroke PAA recognition identified hospitals providing higher conformity with care measures for patients hospitalized with acute ischemic stroke, PAA recognition was a more robust identifier of hospitals with better performance.
Type
Journal article
Subject
Primary Stroke Center certification
acute stroke
measures registry
Achievement
Acute Disease
Aged
Aged, 80 and over
Awards and Prizes
Brain Ischemia
Certification
Female
Hospitals
Humans
Male
Middle Aged
Quality of Health Care
Stroke
Permalink
https://hdl.handle.net/10161/15018
Published Version (Please cite this version)
10.1161/JAHA.113.000451
Publication Info
Fonarow, Gregg C; Liang, Li; Smith, Eric E; Reeves, Mathew J; Saver, Jeffrey L; Xian, Ying; ... GWTG-Stroke Steering Committee & Investigators (2013). Comparison of performance achievement award recognition with primary stroke center certification for acute ischemic stroke care. J Am Heart Assoc, 2(5). pp. e000451. 10.1161/JAHA.113.000451. Retrieved from https://hdl.handle.net/10161/15018.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Hernandez

Adrian Felipe Hernandez

Duke Health Cardiology Professor
Peterson

Eric David Peterson

Fred Cobb, M.D. Distinguished Professor of Medicine
Dr Peterson is the Fred Cobb Distinguished Professor of Medicine in the Division of Cardiology, a DukeMed Scholar, and the Past Executive Director of the Duke Clinical Research Institute (DCRI), Durham, NC, USA. Dr Peterson is the Principal Investigator of the National Institute of Health, Lung and Blood Institute (NHLBI) Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction (SPIRRIT) Trial  He is also the Principal I
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.

Ying Xian

Adjunct Associate Professor in the Department of Neurology
Alphabetical list of authors with Scholars@Duke profiles.
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