Arto Ohinmaa1, Yufei Zheng2, Thomas Jeerakathil3, Scott Klarenbach4, Unto Häkkinen5, Thanh Nguyen6, Dan Friesen7, Jane Ruseski8, Padma Kaul9, Ruolz Ariste10, Philip Jacobs2. 1. School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Institute of Health Economics, Edmonton, Alberta, Canada. Electronic address: arto.ohinmaa@ualberta.ca. 2. Institute of Health Economics, Edmonton, Alberta, Canada; Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. 3. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Health Services, Edmonton, Alberta, Canada. 4. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. 5. National Institute for Health and Welfare, Helsinki, Finland. 6. School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Institute of Health Economics, Edmonton, Alberta, Canada. 7. Alberta Medical Association, Edmonton, Alberta, Canada. 8. West Virginia University, Morgantown, West Virginia. 9. School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. 10. Canadian Institute for Health Information, Ottawa, Ontario, Canada.
Abstract
OBJECTIVES: This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy. METHODS: New ischemic stroke patients (N = 7632) admitted to Alberta acute care hospitals between 2006 and 2011 were followed for 1 year. We analyzed in-hospital mortality with logistic regression, LOS with negative binomial regression, and the hospital costs with generalized gamma model (log link). The risk-adjusted results were compared over years and between zones using observed/expected results. RESULTS: The risk-adjusted mortality rates decreased from 12.6% in 2006/2007 to 9.9% in 2010/2011. The regional variations in mortality decreased from 8.3% units in 2008/2009 to 5.6 in 2010/2011. The LOS of the first episode dropped significantly in 2010/2011 after a 4-year slight increase. The regional variation in LOS was 15.5 days in 2006/2007 and decreased to 10.9 days in 2010/2011. The 1-year hospitalization cost increased initially, and then kept on declining during the last 3 years. The South and Calgary zones had the lowest costs over the study period. However, this gap was diminishing. CONCLUSIONS: After implementation of the Alberta Provincial Stroke Strategy, both mortality and hospital costs demonstrated a decreasing trend during the later years of study. The LOS increased slightly during the first 4 years but had a significant drop at the last year. In general, the regional variations in all 3 indicators had a diminishing trend.
OBJECTIVES: This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy. METHODS: New ischemic strokepatients (N = 7632) admitted to Alberta acute care hospitals between 2006 and 2011 were followed for 1 year. We analyzed in-hospital mortality with logistic regression, LOS with negative binomial regression, and the hospital costs with generalized gamma model (log link). The risk-adjusted results were compared over years and between zones using observed/expected results. RESULTS: The risk-adjusted mortality rates decreased from 12.6% in 2006/2007 to 9.9% in 2010/2011. The regional variations in mortality decreased from 8.3% units in 2008/2009 to 5.6 in 2010/2011. The LOS of the first episode dropped significantly in 2010/2011 after a 4-year slight increase. The regional variation in LOS was 15.5 days in 2006/2007 and decreased to 10.9 days in 2010/2011. The 1-year hospitalization cost increased initially, and then kept on declining during the last 3 years. The South and Calgary zones had the lowest costs over the study period. However, this gap was diminishing. CONCLUSIONS: After implementation of the Alberta Provincial Stroke Strategy, both mortality and hospital costs demonstrated a decreasing trend during the later years of study. The LOS increased slightly during the first 4 years but had a significant drop at the last year. In general, the regional variations in all 3 indicators had a diminishing trend.
Authors: Benjamin Enns; Jeong Eun Min; Dimitra Panagiotoglou; Julio S G Montaner; Bohdan Nosyk Journal: BMC Health Serv Res Date: 2019-09-03 Impact factor: 2.655
Authors: Sergei Muratov; Justin Lee; Anne Holbrook; Andrew Costa; J Michael Paterson; Jason R Guertin; Lawrence Mbuagbaw; Tara Gomes; Wayne Khuu; Jean-Eric Tarride Journal: BMC Geriatr Date: 2018-11-01 Impact factor: 3.921