Details

Autor(en) / Beteiligte

• Ren, Nice
• Nishimura, Ataru
• Kurogi, Ai
• Nishimura, Kunihiro
• Matsuo, Ryu
• Ogasawara, Kuniaki
• Hashimoto, Yoichiro
• Higashi, Takahiro
• Sakai, Nobuyuki
• Toyoda, Kazunori
• Shiokawa, Yoshiaki
• Tominaga, Teiji
• Miyachi, Shigeru
• Kada, Akiko
• Abe, Keisuke
• Ono, Kotaro
• Matsumizu, Kazunori
• Arimura, Koichi
• Kitazono, Takanari
• Miyamoto, Susumu
• Minematsu, Kazuo
• Iihara, Koji

Titel

Measuring Quality of Care for Ischemic Stroke Treated With Acute Reperfusion Therapy in Japan　― The Close The Gap-Stroke

Ist Teil von

• Circulation Journal, 2020/11/20, pp.CJ-20-0639

Ort / Verlag

The Japanese Circulation Society

Erscheinungsjahr

2020

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background:In Japan there is no consensus on how to efficiently measure quality indicators (QIs), defined as a standard of care, for acute ischemic stroke (AIS). Using information from a health insurance claims database and electronic medical records, we evaluated the feasibility and validity of measuring QIs for AIS patients who received intravenous recombinant tissue plasminogen activator (IV rt-PA) or endovascular therapy (EVT).Methods and Results:AIS patients receiving rt-PA or EVT between 2013 and 2015 were identified. We selected 17 AIS QI measures for primary stroke centers (PSCs) and 8 for comprehensive stroke centers (CSCs). Defined QIs were calculated for each hospital and then averaged. In total, the data of 8,206 patients (rt-PA 83.7%, EVT 34.9%) from 172 hospitals were obtained. Median National Institute of Health Stroke Scale score at admission was 14, and 37.7% of the patients were functionally independent at discharge. All target QIs were successfully measured with fewer missing values, and the accuracy of preset data was about 90%. Adherence rates were low (<50%) in 5 QI measures among PSCs, including door-to-needle time ≤1 h, and in 1 QI measure among CSCs (door-to-brain and vascular imaging time ≤30 min).Conclusions:Measuring QIs for AIS by this novel approach was feasible and reliable in the provision of a national benchmark.