国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
GRP per capita and hospital characteristics associated with intravenous tissue plasminogen activator adherence rate: evidence from the Chinese Stroke Center Alliance
基本信息
- 负责人：Suxi Zheng,Tian Jie Lyu
- 数据来源： CSCA
- 论文编号：CSCA20190940
- 发表时间：2021-01-11
2021-01-11
已发表文章
发表杂志：Stroke and Vascular Neurology
发表类型: Original Research
影响因子(IF): 4.081
PMID: 10.1136/svn-2020-000633 Pubmed原文链接 全文下载
主要研究背景及目的
The adherence to guideline-recommended ischemic stroke performance metrics has been getting more and more attention nationwide. It is acknowledged that the overall quality of care has improved over time. However, the regional difference of stroke performance metrices and what factors might affect the stroke performance metrices adherence rate has not been explored yet. This paper focused on adherence rate of the treatment of IV-rtPA among onset-to-door time within 3.5 hours and aimed at studying the regional difference of this adherence rate and its influence factors.
方法
We examined 191389 patients data from the Chinese Stroke Center Alliance for those with acute ischemic stroke from August 2015 to August 2019. ANOVA was used to compare the regional differences of the adherence rate to IV-rtPA. We used correlation test and multivariable linear regression to evaluate the association of adherence rate to IV-rtPA with national statistics including regional GDP per capita, hospital bed density, nurse to bed ratio, doctor to nurse ratio, working days of beds in hospitals, the utilization rate of beds in hospitals and average stay days in hospitals.
结论
The adherence rate of IV-rt PA increased with GRP per capita. Hospitals equipped with more experienced neurologists, more comprehensive emergency services, routine coordination with local emergency centres performed better in adhering to the delivery of IV-rt PA. Our findings provide some evidence that the thrombolysis disparity can be partially explained at the macroeconomic and healthcare system level, not merely attributable to individual factors. The policy-makers should carefully consider medical funding level and medical resource allocation to increase the IV rt-PA usage among eligible acute ischemic stroke patients.