Regional variations in stroke care in England, Wales and Northern Ireland: results from the National Sentinel Audit of stroke

TY - JOUR

T1 - Regional variations in stroke care in England, Wales and Northern Ireland: results from the National Sentinel Audit of stroke

AU - Rudd, A G

AU - Irwin, P

AU - Rutledge, Z

AU - Lowe, D

AU - Wade, D T

AU - Pearson, M

PY - 2001

Y1 - 2001

N2 - Study objective: To identify the variations between regions in England, Wales and Northern Ireland in the case-mix, organization and process of care for stroke. Design: Retrospective audit of case notes and service organization. Setting: Two hundred and ten Trust sites from 197 Trusts in 10 Health Regions in England, Wales and Northern Ireland. Patients: The 6894 consecutive stroke patients admitted between 1 January and 31 March 1998 (up to 40 per Trust). Audit tool: The Intercollegiate Stroke Audit. Results: There are significant differences in stroke care between regions that cannot be explained by known case-mix or clinical variables. The proportion of patients spending more than half their hospital stay in stroke unit care varied between regions from 10% to 27%. Thirty-day mortality in different regions ranged between 21% and 33%. Institutionalization rates for those admitted from home varied between 6% and 19%. Similar variations existed in discharge disability and length of stay. Conclusions: There were widespread variations in specialist service provision for stroke in different regions. Regional variation in 30-day mortality and in institutionalization after stroke is not explained by clinical factors and therefore may represent different local health care policies and expectations.

AB - Study objective: To identify the variations between regions in England, Wales and Northern Ireland in the case-mix, organization and process of care for stroke. Design: Retrospective audit of case notes and service organization. Setting: Two hundred and ten Trust sites from 197 Trusts in 10 Health Regions in England, Wales and Northern Ireland. Patients: The 6894 consecutive stroke patients admitted between 1 January and 31 March 1998 (up to 40 per Trust). Audit tool: The Intercollegiate Stroke Audit. Results: There are significant differences in stroke care between regions that cannot be explained by known case-mix or clinical variables. The proportion of patients spending more than half their hospital stay in stroke unit care varied between regions from 10% to 27%. Thirty-day mortality in different regions ranged between 21% and 33%. Institutionalization rates for those admitted from home varied between 6% and 19%. Similar variations existed in discharge disability and length of stay. Conclusions: There were widespread variations in specialist service provision for stroke in different regions. Regional variation in 30-day mortality and in institutionalization after stroke is not explained by clinical factors and therefore may represent different local health care policies and expectations.

UR - http://www.scopus.com/inward/record.url?scp=0034810319&partnerID=8YFLogxK

U2 - 10.1191/026921501680425289

DO - 10.1191/026921501680425289

M3 - Article

SN - 1477-0873

VL - 15

SP - 562

EP - 572

JO - Clinical Rehabilitation

JF - Clinical Rehabilitation

IS - 5

ER -