Stroke hospital characteristics in the Florida-puerto rico collaboration to reduce stroke disparities study

Maria A. Ciliberti-Vargas, Hannah Gardener, Kefeng Wang, Chuanhui Dong, Li Yi, Jose G Romano, Mary Robichaux, Salina P. Waddy, Ulises Nobo, Sandra Diaz-Acosta, Tatjana Rundek, Michael F. Waters, Ralph L Sacco

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Objectives: Although disparities in stroke care and outcomes have been well documented nationally, state-based registries to monitor acute stroke care in Florida (FL) and Puerto Rico (PR) have not been established. The FL-PR Collaboration to Reduce Stroke Disparities (CReSD) was developed to evaluate race-ethnicity and regional disparities in stroke care performance. The objective of this study was to assess and compare hospital characteristics within a large quality improvement registry to identify characteristics associated with better outcomes for acute ischemic stroke care. Methods: Trained personnel from 78 FL-PR CReSD hospitals (69 FL, 9 PR) completed a 50-item survey assessing institutional characteristics across seven domains: acute stroke care resource availability, emergency medical services integration, stroke center certification, data collection and use, quality improvement processes, FL-PR CReSD recruitment incentives, and hospital infrastructure. Results: The rate of survey completion was 100%. Differences were observed both within FL and between FL and PR. Years participating in GetWith TheGuidelines-Stroke (8.9 ± 2.6 years FL vs 4.8 ± 2.4 years PR, P < 0.0001) and proportion of hospitals with any stroke center certification (94.2% FL vs 11.1% PR, P < 0.0001) showed the largest variations. Smaller hospital size, fewer years in Get With The Guidelines-Stroke, and lack of stroke center designation and acute stroke care practice implementation may contribute to poorer outcomes. Conclusions: Results from our survey indicated variability in hospitaland system-level characteristics in stroke care across hospitals in Florida and Puerto Rico. Identification of these variations, which may explain potential disparities, can help clinicians understand gaps in stroke care and outcomes and targeted interventions to reduce identified disparities can be implemented.

Original languageEnglish (US)
Pages (from-to)466-474
Number of pages9
JournalSouthern Medical Journal
Volume110
Issue number7
DOIs
StatePublished - 2017

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Keywords

  • Cerebrovascular disease/stroke
  • Get With The Guidelines-Stroke
  • Health disparities
  • Quality improvement
  • Race and ethnicity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ciliberti-Vargas, M. A., Gardener, H., Wang, K., Dong, C., Yi, L., Romano, J. G., Robichaux, M., Waddy, S. P., Nobo, U., Diaz-Acosta, S., Rundek, T., Waters, M. F., & Sacco, R. L. (2017). Stroke hospital characteristics in the Florida-puerto rico collaboration to reduce stroke disparities study. Southern Medical Journal, 110(7), 466-474. https://doi.org/10.14423/SMJ.0000000000000667