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Ethnic Comparison of 30-Day Potentially Preventable Readmissions After Stroke in Hawaii Clinical Sciences
Conclusions— In Hawaii, Chinese may have a higher risk of 30-day PPR after stroke compared with whites. However, this seems to be driven by the high number of repeated PPR within the Chinese ethnic group.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Nakagawa, K., Ahn, H. J., Taira, D. A., Miyamura, J., Sentell, T. L. Tags: Race and Ethnicity, Complications, Quality and Outcomes, Cerebrovascular Disease/Stroke Clinical Sciences Source Type: research

Comparative Risk of Ischemic Stroke Among Users of Clopidogrel Together With Individual Proton Pump Inhibitors Clinical Sciences
Conclusions— PPIs of interest did not increase the rate of ischemic stroke among clopidogrel users when compared with pantoprazole, a PPI thought to be devoid of the potential to interact with clopidogrel.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Leonard, C. E., Bilker, W. B., Brensinger, C. M., Flockhart, D. A., Freeman, C. P., Kasner, S. E., Kimmel, S. E., Hennessy, S. Tags: Platelet function inhibitors, Acute Cerebral Infarction, Acute Stroke Syndromes, Antiplatelets, Epidemiology Clinical Sciences Source Type: research

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

Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization Clinical Sciences
Conclusions—We developed 3 quality measures that demonstrate better discrimination than the Centers for Medicare & Medicaid Services’ existing stroke mortality measure, adjust for stroke severity, and could be implemented in a variety of settings.
Source: Stroke - October 23, 2017 Category: Neurology Authors: Jennifer Schwartz, Yongfei Wang, Li Qin, Lee H. Schwamm, Gregg C. Fonarow, Nicole Cormier, Karen Dorsey, Robert L. McNamara, Lisa G. Suter, Harlan M. Krumholz, Susannah M. Bernheim Tags: Health Services, Mortality/Survival, Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research

Stroke Outcomes Measures Must Be Appropriately Risk Adjusted to Ensure Quality Care of Patients: A Presidential Advisory From the American Heart Association/American Stroke Association AHA/ASA Presidential Advisory
This article details (1) why the Centers for Medicare & Medicaid Services acute ischemic stroke outcome measures in their present form may not provide adequate risk adjustment, (2) why the measures as currently designed may lead to inaccurate representation of hospital performance and have the potential for serious unintended consequences, (3) what activities the American Heart Association/American Stroke Association has engaged in to highlight these concerns to the Centers for Medicare & Medicaid Services and other interested parties, and (4) alternative approaches and opportunities that should be considered for m...
Source: Stroke - April 28, 2014 Category: Neurology Authors: Fonarow, G. C., Alberts, M. J., Broderick, J. P., Jauch, E. C., Kleindorfer, D. O., Saver, J. L., Solis, P., Suter, R., Schwamm, L. H. Tags: AHA Statements and Guidelines AHA/ASA Presidential Advisory Source Type: research

Impact of State Medicaid Coverage on Utilization of Inpatient Rehabilitation Facilities Among Patients With Stroke Brief Reports
Conclusions— State Medicaid coverage of IRFs is associated with IRF utilization among stroke patients with Medicaid. Given the increasing stroke incidence among the working age and Medicaid expansion under the Affordable Care Act, careful attention to state Medicaid policy for poststroke rehabilitation and analysis of its effects on stroke outcome disparities are warranted.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Skolarus, L. E., Burke, J. F., Morgenstern, L. B., Meurer, W. J., Adelman, E. E., Kerber, K. A., Callaghan, B. C., Lisabeth, L. D. Tags: Health policy and outcome research Brief Reports Source Type: research

Preventable Readmissions Within 30 Days of Ischemic Stroke Among Medicare Beneficiaries Clinical Sciences
Conclusions— On the basis of Agency for Healthcare Research and Quality Prevention Quality Indicators, we found that a small proportion of readmissions after ischemic stroke were classified as preventable. Although other causes of readmissions not reflected in the Agency for Healthcare Research and Quality measures could also be avoidable, hospital-level programs intended to reduce all-cause readmissions and costs should target high-risk patients.
Source: Stroke - November 25, 2013 Category: Neurology Authors: Lichtman, J. H., Leifheit-Limson, E. C., Jones, S. B., Wang, Y., Goldstein, L. B. Tags: Clinical Sciences Source Type: research

Cost of Alteplase Has More Than Doubled Over the Past Decade Brief Report
Conclusions—We found a striking increase in the cost of alteplase over the last decade, with a 100 mg vial now with a CMS payment of ≈$6400, a>100% increase over 10 years. During the same time frame, the DRG base payment to hospitals increased by only 8%, and alteplase cost increased from 27% of the payment in 2006 to 53% in 2013. Researchers and stroke physicians should be aware of these changes in drug costs and their impact on cost-effectiveness analyses.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Dawn Kleindorfer, Joseph Broderick, Bart Demaerschalk, Jeffrey Saver Tags: Cost-Effectiveness, Ischemic Stroke Brief Reports Source Type: research

Factors Associated With Length of Hospitalization in Patients Admitted With Transient Ischemic Attack in United States Clinical Sciences
Conclusions— Approximately 75% of patients admitted with transient ischemic attack stay in the hospital for ≥2 days, with the most important determinants being pre-existing medical comorbidities. Longer duration of hospital stay is associated with 2- to 5-fold greater hospitalization charges.
Source: Stroke - May 24, 2013 Category: Neurology Authors: Qureshi, A. I., Adil, M. M., Zacharatos, H., Suri, M. F. K. Tags: Transient Ischemic Attacks Clinical Sciences Source Type: research

Centers for Medicare and Medicaid Services Medicare Data and Stroke Research: Goldmine or Landmine? Topical Reviews
Source: Stroke - January 26, 2015 Category: Neurology Authors: Lichtman, J. H., Leifheit-Limson, E. C., Goldstein, L. B. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Topical Reviews Source Type: research

Racial and Socioeconomic Disparities in Gastrostomy Tube Placement After Intracerebral Hemorrhage in the United States Clinical Sciences
Conclusions— Minority race, Medicaid enrollment, and low household income are associated with PEG placement after ICH.
Source: Stroke - March 27, 2016 Category: Neurology Authors: Faigle, R., Bahouth, M. N., Urrutia, V. C., Gottesman, R. F. Tags: Intracranial Hemorrhage Clinical Sciences Source Type: research