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Disparities in Accessibility of Certified Primary Stroke Centers Clinical Sciences
Conclusions— There are significant geographic disparities in access to PSCs. Access is limited in nonurban areas. Despite the higher burden of cerebrovascular disease in stroke belt states, access to care is lower in these areas. Selecting demographic and healthcare factors is strongly associated with access to care in smaller cities, but not in other areas, including major cities.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Mullen, M. T., Wiebe, D. J., Bowman, A., Wolff, C. S., Albright, K. C., Roy, J., Balcer, L. J., Branas, C. C., Carr, B. G. Tags: Health policy and outcome research, Emergency treatment of Stroke Clinical Sciences Source Type: research

Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
Backgound: Few studies have examined associations among insurance status, treatment, and outcomes in patients hospitalized for intracerebral hemorrhage (ICH).Methods: Through retrospective analyses of the Get With The Guidelines (GWTG)-Stroke database, a national prospective stroke registry, from April 2003 to April 2011, we identified 95,986 nontransferred subjects hospitalized with ICH. Insurance status was categorized as Private/Other, Medicaid, Medicare, or None/Not Documented (ND). Associations between insurance status and in-hospital outcomes and quality of care measures were analyzed using patient- and hospital-spec...
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2013 Category: Neurology Authors: Michael L. James, Maria V. Grau-Sepulveda, DaiWai M. Olson, Eric E. Smith, Adrian F. Hernandez, Eric D. Peterson, Lee H. Schwamm, Deepak L. Bhatt, Gregg C. Fonarow Tags: Original Articles Source Type: research

Abstract 237: Anticoagulant Use For the Prevention of Stroke in Patients with Atrial Fibrillation: Findings From a Multi-Payer Analysis Poster Session II
Conclusions: Many AF patients in selected commercial, Medicare-eligible, and Medicaid populations, including those at high risk of stroke, do not receive appropriate thromboprophylaxis, as recommended by treatment guidelines. Increased use of the analyzer and similar software may support enhanced education efforts aimed at improving adherence to guidelines and quality of care.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Lang, K., Bozkaya, D., Patel, A. A., Macomson, B., Nelson, W., Owens, G., Mody, S. Tags: Poster Session II Source Type: research

Retention of Stroke Education Provided during Hospitalization: Does Provision of Required Education Increase Stroke Knowledge?
Discussion: While stroke education is required during hospitalization, its ability to produce retention may be poor. We propose study of test-enhanced learning methods through the Targeted Education in Stroke Trial (TEST) to examine the effect of novel teaching methods on patient/caregiver knowledge retention.Intervent Neurol 2018;7:471 –478
Source: Interventional Neurology - July 26, 2018 Category: Neurology Source Type: research

Identification of reversible causes of minority inequity in stroke: severity related to race and socio-economic status.
CONCLUSIONS: Patients who are uninsured minorities may be at an increased risk for severe strokes. This increase in risk appears to be related to the increased incidence of risk factors and lack of treatment. The lack of funds, care access, and limited education in these patients may be related to their increase in risk factors. This paper identifies potentially reversible environmental and societal factors that can lead to improved outcomes in indigent minority patients. PMID: 30325276 [PubMed - in process]
Source: Brain Injury - October 17, 2018 Category: Neurology Tags: Brain Inj Source Type: research

Getting to the Core of Stroke Care: Real Time Chart Review Improves Hospital Compliance with Core Measures (P6.269)
Conclusions:Real time chart review, utilization of a MQA, and alerting of providers is significantly more effective than a process utilizing retrospective chart review based on sampling and manual abstraction in increasing CM compliance. Implementation of these methods reduces CM deficiencies and leads to improved stroke care.Disclosure: Dr. Katsafanas has nothing to disclose. Dr. Furbeyre has nothing to disclose. Dr. Coppen has nothing to disclose. Dr. Hodges has nothing to disclose. Dr. Schnepel has nothing to disclose. Dr. Falk has nothing to disclose. Dr. Alonso has nothing to disclose. Dr. Tran has nothing to disclose...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Katsafanas, C., Furbeyre, J., Coppen, V., Hodges, W., Schnepel, L., Falk, D., Alonso, J., Tran, A., Northcut, M., Toback, A., Silliman, S. Tags: Cerebrovascular Disease Health Services Research Source Type: research

Show or No-Show - That Is the Question: Lack of Outpatient Follow-up a After Acute Stroke. (P2.131)
CONCLUSION: Poor follow up rates were seen overall. Medicare, Medicaid, and self-pay patients were least likely to follow up. Patients discharged to inpatient rehabilitation or nursing facilities had a low follow-up rate, as did those patients living at a geographic distance from our facilities. Better education of the importance of follow-up prior to discharge is needed.Disclosure: Dr. Chaudhary has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chaudhary, G., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Evaluation, Cost, and Quality Source Type: research

National trends in utilization of Intravenous thrombolysis and endovascular treatment in acute ischemic stroke (P5.044)
Conclusions:At national level, use of intravenous rt-PA is increasing among all groups proving positive impact of the efforts by organizations and patient education. Given endovascular treatment has now become standard of care; we need to create stroke care models to target this most vulnerable subset of patient population including Hispanics, patients residing in rural areas and insurance status like Medicaid or self-pay status to provide them similar and equal opportunities of treatment as others.Disclosure: Dr. Khatri has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Qu...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Khatri, R., rauf-afzal, m., Qureshi, M. A., Qureshi, I. A., Maud, A., Rodriguez, G., Cruz-Flores, S. Tags: Neurocritical Care: Ischemic Injury Source Type: research

The Role of Neighborhoods in the Receipt of Transcranial Doppler Screening Among Children With Sickle Cell Disease
Although transcranial Doppler (TCD) screening assesses the need for stroke prevention efforts among children with sickle cell disease (SCD), screening rates remain low across many parts of the United States. We sought to identify neighborhoods with low TCD screening rates and neighborhood-level factors related to screening to inform the utility of community-level interventions to improve TCD screening. Children ages 2 to 16 years with SCD (HbSS/HbS/β-thalassemia) living in Wayne County, MI, were identified in Michigan Medicaid (2007 to 2011) through newborn screening records. Children were enrolled for ≥1 year and could...
Source: Journal of Pediatric Hematology Oncology - April 21, 2015 Category: Hematology Tags: Original Articles Source Type: research

Abstract 150: Resource Utilization Patterns and Outcomes Among Acute Coronary Syndrome Patients: Findings From a Multi-Payer Analysis Poster Session II
Conclusion: These findings suggest that many patients with ACS do not receive appropriate recommended antithrombotic prophylaxis, and opportunities exist to improve therapy. Increased use of software tools such as AQuA may support enhanced education efforts aimed at improving adherence to guidelines and quality of care.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Lang, K., Bozkaya, D., Patel, A. A., Macomson, B., Crivera, C., Owens, G., Mody, S. Tags: Poster Session II Source Type: research

Many African Americans Still Only Dream of High Quality Health Care
Recently, AARP conducted a study to determine how perceptions of key social issues ranked in importance to African Americans age 50 and over. Ninety-one percent gave the answer "high quality health care." Eighty-nine percent gave the answer, "Access to high quality health care information." We were not surprised at the high percentage of either response. Why wouldn't the foremost issue on the minds of African Americans be the key issue that would prolong, enhance or save lives? Why wouldn't the dominant issue on the minds of Black people age 50 and over be their health; even more so than education, employment and access t...
Source: Healthy Living - The Huffington Post - February 16, 2015 Category: Consumer Health News Source Type: news

The Quality Of Health Care You Receive Likely Depends On Your Skin Color
Unequal health care continues to be a serious problem for black Americans. More than a decade after the Institute of Medicine issued a landmark report showing that minority patients were less likely to receive the same quality health care as white patients, racial and ethnic disparities continue to plague the U.S. health care system. That report, which was published in 2002, indicated that even when both groups had similar insurance or the same ability to pay for care, black patients received inferior treatment to white patients. This still hold true, according to our investigation into dozens of studies about black health...
Source: Healthy Living - The Huffington Post - June 29, 2015 Category: Consumer Health News Source Type: news

Characteristics of Accredited Transcranial Doppler Ultrasound Laboratories in the United States
CONCLUSIONSThe results suggest that there are significant differences between IAC applicant laboratories and laboratories represented by Centers for Medicaid and Medicare Services (CMS) claims data. In addition, accurate study reporting, physician training, and ongoing quality improvement activities may not be optimized in laboratories applying for accreditation. With the information learned from this study, educational strategies by professional organizations, including the IAC, can be tailored to help improve TCD practice.
Source: Journal of Neuroimaging - October 31, 2016 Category: Radiology Authors: Mary Beth Farrell, John Y. Choi, Endrit Ziu, Kevin M. Cockroft Tags: Technology Update Source Type: research

Abstract 043: Health Insurance and the Risk of Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis Session Title: Poster Session I
Conclusions: The association of health insurance with CVD incidence varied by insurance group, and private insurance was associated with a lower risk of incident CVD. Further exploration of the features of health insurance coverage that impact CVD incidence may facilitate improvements in the primary prevention of CVD.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Crim, M. T., Xie, J. X., Ko, Y.-A., Blumenthal, R. S., Blaha, M. J., Nasir, K., Budoff, M. J., Shaw, L. J. Tags: Session Title: Poster Session I Source Type: research

Urine Arsenic and Arsenic Metabolites in U.S. Adults and Biomarkers of Inflammation, Oxidative Stress, and Endothelial Dysfunction: A Cross-Sectional Study
Conclusion: In a cross-sectional study of U.S. adults, we observed some positive associations of uAs and toenail As concentrations with biomarkers potentially relevant to CVD pathogenesis and inflammation, and evidence of a higher capacity to metabolize inorganic As was negatively associated with a marker of oxidative stress. https://doi.org/10.1289/EHP2062 Received: 14 April 2017 Revised: 13 November 2017 Accepted: 15 November 2017 Published: 15 December 2017 Address correspondence to S.F. Farzan, 2001 N. Soto St., Los Angeles, CA, 90032. Telephone: (323)-442-5101; Email: sffarzan@usc.edu Supplemental Material is ava...
Source: EHP Research - December 16, 2017 Category: Environmental Health Authors: Daniil Lyalko Tags: Research Source Type: research

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