Abstract WP381: Hospital Participation and Performance in Stroke Systems of Care: Results from The NorthEast Cerebrovascular Consortium (NECC) Region
INTRODUCTION: The NorthEast Cerebrovascular Consortium (NECC) was created in 2006 to unite health care providers, public health officials and advocacy organizations in an 8-state region to implement a Stroke Systems of Care Model.
Hypothesis: Implementation of The NECC has been associated with increased participation in Get With the Guidelines - Stroke (GWTG-S) and higher performance ratings of acute care hospitals (ACH) and critical access centers (CAC).
Methods: A two-tiered analysis of all ACH/CACs in The NECC region compared (1): GWTG-S participation and award trends over time in the pre (2005) and post (2006-11) NECC time periods, and (2) The NECC region compared to all other US regions from 2005-11. Analysis used US census data regions stratified as The NECC (CT, MA, ME, NH, NJ, NY, RI, VT) and Non-NECC regions (PA, South, Midwest, West). ACH/CACs were obtained from CMS. GWTG-S data were used for GWTG-S participation and awards (silver or higher for >1 year indicated sustained performance).
Results: Over the study time period (2005-11) the ACH/CACs per year in The NECC and non-NECC regions were 442.1 + 8.2 and 3958.7 + 204.4. In The NECC region GWTG-S participation increased over time from 22.8% in 2005 to 60.7% in 2011 compared to 10.1% in 2005 to 31.0% in 2011 in non-NECC regions (both analyses p<0.0001, Cochran Armitage Trend test). GWTG-S awards increased over time in The NECC from 0.5% in 2005 to 33.4% in 2011 compared to 0.1% in 2005 to 12.0% in 2011 in non-NECC regions (both analyses p<0.0001, Cochran Armitage Trend test). After adjusting for year, significantly more NECC ACH/CACs participated in GWTG-S and received GWTG-S awards than non-NECC ACH/CACs (both analyses p<0.0001, Cochran-Mantel-Haenszel test). Among ACHs only, the trends for increased GWTG-S participation and awards over time as well as the differences between NECC vs. non-NECC regions remained significant (P<0.0001, Cochran Armitage Trend tests; p<0.0001, Cochran-Mantel-Haenszel tests).
Conclusions: There has been more rapid growth of ACH/CAC participation and achievement in GWTG-S in the Northeast from 2006-11 compared to other regions. The NECC may complement and enhance existing regulatory and advocacy initiatives. Further investigation is merited evaluating regional networks.
- © 2012 by American Heart Association, Inc.