National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedPrabhakaran S, Khorzad R, Parnianpour Z
Door-in-door-out process times at primary stroke centers in Chicago.
This study sought to identify modifiable predictors of door-in-door-out times for transfer of acute stroke patients from primary stroke centers to comprehensive stroke centers using 3 Chicago-region primary stroke centers as a model. A retrospective analysis of consecutive patients with acute stroke from February 2018 to January 2020 who required transfer from 1 of 3 primary stroke centers to 1 of 3 affiliated comprehensive stroke centers was conducted. Of 191 total patients, 67.9% arrived by emergency medical services and 57.4% during off-hours. Telestroke was performed in 84.2% of patients, 30.5% received alteplase, and 48.4% underwent a computed tomography (CT) at the primary stroke center. The median door-in-door-out time was 148.5 minutes. The largest contributors to longer door-in-door-out times were CT to CT angiography time, transfer center contact to ambulance request time, ambulance request to arrive time, and transfer ambulance at primary stroke center. Other factors included CT angiography performed at the primary stroke center, walk-in arrival mode, administration of intravenous alteplase request by primary stroke center, and ambulance request by the primary stroke center.
AHRQ-funded; HS025359.
Citation: Prabhakaran S, Khorzad R, Parnianpour Z .
Door-in-door-out process times at primary stroke centers in Chicago.
Ann Emerg Med 2021 Nov;78(5):674-81. doi: 10.1016/j.annemergmed.2021.06.018..
Keywords: Stroke, Cardiovascular Conditions, Healthcare Delivery, Emergency Department
Etherton MR, Zachrison KS, Yan Z
Regional changes in patterns of stroke presentation during the COVID-19 pandemic.
The authors sought to determine the effect of the coronavirus pandemic on patterns of stroke patient presentation and quality of care. They analyzed data from 25 New England hospitals: one urban, academic, comprehensive stroke center and telestroke hub, and 24 spoke hospitals in the same telestroke network. They included all telestroke consultations from the 24 spokes, and stroke admissions to the comprehensive stroke center hub from November 2019 through April 2020. They compared rates of presentation, timeliness presentation, and quality of care pre- versus post-March 2020. They also examined trends in patient demographics, stroke severity, timeliness, diagnosis including large vessel occlusion, alteplase use, and endovascular thrombectomy among eligible subjects. Among 1248 patient presentations, telestroke consultations and ischemic stroke patient admissions decreased through the hub and spoke network. Age and stroke severity were unchanged during the study period. However, rates of adherence for the quality measures dysphagia screening, early antithrombotic initiation, and early venous thromboembolism prophylaxis were reduced during the pandemic.
AHRQ-funded; HS024561.
Citation: Etherton MR, Zachrison KS, Yan Z .
Regional changes in patterns of stroke presentation during the COVID-19 pandemic.
Stroke 2021 Apr;52(4):1398-406. doi: 10.1161/strokeaha.120.031300..
Keywords: Stroke, Cardiovascular Conditions, COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Aparicio HJ, Carr BG, Kasner SE
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
The researechers found that racial disparities in intravenous recombinant tissue plasminogen activator (rt-PA) use were not reduced by presentation to primary stroke centers (PSCs). Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.
AHRQ-funded; HS018362; HS017960; HS013852.
Citation: Aparicio HJ, Carr BG, Kasner SE .
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
J Am Heart Assoc 2015 Oct 14;4(10):e001877. doi: 10.1161/jaha.115.001877.
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Keywords: Healthcare Delivery, Disparities, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Stroke