Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke

Sarah Song, Gregg C. Fonarow, Dai Wai M Olson, Li Liang, Phillip J. Schulte, Adrian F. Hernandez, Eric D. Peterson, Mathew J. Reeves, Eric E. Smith, Lee H. Schwamm, Jeffrey L. Saver

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and Purpose - Get With The Guidelines (GWTG)-Stroke is a national, hospital-based quality improvement program developed by the American Heart Association. Although studies have suggested improved processes of care in GWTG-Stroke-participating hospitals, it is not known whether this improved care translates into improved clinical outcomes compared with nonparticipating hospitals. Methods - From all acute care US hospitals caring for Medicare beneficiaries with acute stroke between April 2003 and December 2008, we matched hospitals that joined the GWTG-Stroke program with similar hospitals that did not. Using a difference-in-differences design, we analyzed whether hospital participation in GWTG-Stroke was associated with a greater improvement in clinical outcomes compared with the underlying secular change. Results - The matching algorithm identified 366 GWTG-Stroke-adopting hospitals that cared for 88 584 acute ischemic stroke admissions and 366 non-GWTG-Stroke hospitals that cared for 85 401 acute ischemic stroke admissions. Compared with the Pre period (18-6 months before program implementation), in the Early period (0-6 months after program implementation), GWTG-Stroke hospitals had accelerated increases in discharge to home and reduced mortality at 30 days and 1 year. In the Sustained period (6-18 months after program implementation), the accelerated reduction in mortality at 1 year was sustained, with a trend toward sustained accelerated increase in discharge home. Conclusions - Hospital adoption of the GWTG-Stroke program was associated with improved functional outcomes at discharge and reduced postdischarge mortality.

Original languageEnglish (US)
Pages (from-to)1294-1302
Number of pages9
JournalStroke
Volume47
Issue number5
DOIs
StatePublished - May 1 2016

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Medicare
Stroke
Guidelines
Mortality
Quality Improvement

Keywords

  • Medicare
  • patient discharge
  • quality improvement
  • quality of health care
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke. / Song, Sarah; Fonarow, Gregg C.; Olson, Dai Wai M; Liang, Li; Schulte, Phillip J.; Hernandez, Adrian F.; Peterson, Eric D.; Reeves, Mathew J.; Smith, Eric E.; Schwamm, Lee H.; Saver, Jeffrey L.

In: Stroke, Vol. 47, No. 5, 01.05.2016, p. 1294-1302.

Research output: Contribution to journalArticle

Song, S, Fonarow, GC, Olson, DWM, Liang, L, Schulte, PJ, Hernandez, AF, Peterson, ED, Reeves, MJ, Smith, EE, Schwamm, LH & Saver, JL 2016, 'Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke', Stroke, vol. 47, no. 5, pp. 1294-1302. https://doi.org/10.1161/STROKEAHA.115.011874
Song, Sarah ; Fonarow, Gregg C. ; Olson, Dai Wai M ; Liang, Li ; Schulte, Phillip J. ; Hernandez, Adrian F. ; Peterson, Eric D. ; Reeves, Mathew J. ; Smith, Eric E. ; Schwamm, Lee H. ; Saver, Jeffrey L. / Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke. In: Stroke. 2016 ; Vol. 47, No. 5. pp. 1294-1302.
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AU - Schulte, Phillip J.

AU - Hernandez, Adrian F.

AU - Peterson, Eric D.

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