NDLI: Trends and Regional Variation in Hospital Mortality, Length of Stay and Cost in Hospital of Ischemic Stroke Patients in Alberta Accompanying the Provincial Reorganization of Stroke Care.

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Trends and Regional Variation in Hospital Mortality, Length of Stay and Cost in Hospital of Ischemic Stroke Patients in Alberta Accompanying the Provincial Reorganization of Stroke Care.

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Henry J.M. Barnett, MD, FRCP (C).

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Trends and Regional Variation in Hospital Mortality, Length of Stay and Cost in Hospital of Ischemic Stroke Patients in Alberta Accompanying the Provincial Reorganization of Stroke Care.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ohinmaa, Arto Zheng, Yufei Jeerakathil, Thomas Klarenbach, Scott Häkkinen, Unto Nguyen, Thanh Friesen, Dan Ruseski, Jane Kaul, Padma Ariste, Ruolz Jacobs, Philip
Description	Author Affiliation: Ohinmaa A ( School of Public Health, University of Alberta, Edmonton, Alberta, Canada); Zheng Y ( Institute of Health Economics, Edmonton, Alberta, Canada); Jeerakathil T ( Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada); Klarenbach S ( Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.); Häkkinen U ( National Institute for Health and Welfare, Helsinki, Finland.); Nguyen T ( School of Public Health, University of Alberta, Edmonton, Alberta, Canada); Friesen D ( Alberta Medical Association, Edmonton, Alberta, Canada.); Ruseski J ( West Virginia University, Morgantown, West Virginia.); Kaul P ( School of Public Health, University of Alberta, Edmonton, Alberta, Canada); Ariste R ( Canadian Institute for Health Information, Ottawa, Ontario, Canada.); Jacobs P ( Institute of Health Economics, Edmonton, Alberta, Canada)
Abstract	OBJECTIVES: This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy. METHODS: New ischemic stroke patients (N = 7632) admitted to Alberta acute care hospitals between 2006 and 2011 were followed for 1 year. We analyzed in-hospital mortality with logistic regression, LOS with negative binomial regression, and the hospital costs with generalized gamma model (log link). The risk-adjusted results were compared over years and between zones using observed/expected results. RESULTS: The risk-adjusted mortality rates decreased from 12.6% in 2006/2007 to 9.9% in 2010/2011. The regional variations in mortality decreased from 8.3% units in 2008/2009 to 5.6 in 2010/2011. The LOS of the first episode dropped significantly in 2010/2011 after a 4-year slight increase. The regional variation in LOS was 15.5 days in 2006/2007 and decreased to 10.9 days in 2010/2011. The 1-year hospitalization cost increased initially, and then kept on declining during the last 3 years. The South and Calgary zones had the lowest costs over the study period. However, this gap was diminishing. CONCLUSIONS: After implementation of the Alberta Provincial Stroke Strategy, both mortality and hospital costs demonstrated a decreasing trend during the later years of study. The LOS increased slightly during the first 4 years but had a significant drop at the last year. In general, the regional variations in all 3 indicators had a diminishing trend.
File Format	HTM / HTML
ISSN	10523057
Issue Number	12
Journal	Journal of Stroke and Cerebrovascular Diseases
Volume Number	25
e-ISSN	15328511
Language	English
Publisher	Elsevier
Publisher Date	2016-12-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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