Advanced

Hospital comparison of stroke care in Sweden : A register-based study

Lekander, Ingrid; Willers, Carl; Ekstrand, Elisabeth LU ; Von Euler, Mia; Fagervall-Yttling, Birgitta; Henricson, Lena; Kostulas, Konstantinos; Lilja, Mikael; Sunnerhagen, Katharina S. and Teichert, Jörg, et al. (2017) In BMJ Open 7(9).
Abstract

Background and purpose The objective of this study was to estimate the level of health outcomes and resource use at a hospital level during the first year after a stroke, and to identify any potential differences between hospitals after adjusting for patient characteristics (case mix). Method Data from several registries were linked on individual level: seven regional patient administrative systems, Swedish Stroke Register, Statistics Sweden, National Board of Health and Welfare and Swedish Social Insurance Agency. The study population consisted of 14 125 patients presenting with a stroke during 2010. Case-mix adjusted analysis of hospital differences was made on five aspects of health outcomes and resource use, 1 year post-stroke.... (More)

Background and purpose The objective of this study was to estimate the level of health outcomes and resource use at a hospital level during the first year after a stroke, and to identify any potential differences between hospitals after adjusting for patient characteristics (case mix). Method Data from several registries were linked on individual level: seven regional patient administrative systems, Swedish Stroke Register, Statistics Sweden, National Board of Health and Welfare and Swedish Social Insurance Agency. The study population consisted of 14 125 patients presenting with a stroke during 2010. Case-mix adjusted analysis of hospital differences was made on five aspects of health outcomes and resource use, 1 year post-stroke. Results The results indicated that 26% of patients had died within a year of their stroke. Among those who survived, almost 5% had a recurrent stroke and 40% were left with a disability. On average, the patients had 22 inpatient days and 23 outpatient visits, and 13% had moved into special housing. There were significant variations between hospitals in levels of health outcomes achieved and resources used after adjusting for case mix. Conclusion Differences in health outcomes and resource use between hospitals were substantial and not entirely explained by differences in patient mix, indicating tendencies of unequal stroke care in Sweden. Healthcare organisation of regions and other structural features could potentially explain parts of the differences identified.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
case-mix adjustment, health outcomes, inequalities, resource use, value-based healthcare
in
BMJ Open
volume
7
issue
9
publisher
British Medical Journal Publishing Group
external identifiers
  • scopus:85029112119
  • pmid:28882906
  • wos:000412650700042
ISSN
2044-6055
DOI
10.1136/bmjopen-2016-015244
language
English
LU publication?
yes
id
c1ac8f8b-2373-434c-9d0c-e830bea78506
date added to LUP
2017-10-10 11:01:56
date last changed
2018-01-16 13:22:25
@article{c1ac8f8b-2373-434c-9d0c-e830bea78506,
  abstract     = {<p>Background and purpose The objective of this study was to estimate the level of health outcomes and resource use at a hospital level during the first year after a stroke, and to identify any potential differences between hospitals after adjusting for patient characteristics (case mix). Method Data from several registries were linked on individual level: seven regional patient administrative systems, Swedish Stroke Register, Statistics Sweden, National Board of Health and Welfare and Swedish Social Insurance Agency. The study population consisted of 14 125 patients presenting with a stroke during 2010. Case-mix adjusted analysis of hospital differences was made on five aspects of health outcomes and resource use, 1 year post-stroke. Results The results indicated that 26% of patients had died within a year of their stroke. Among those who survived, almost 5% had a recurrent stroke and 40% were left with a disability. On average, the patients had 22 inpatient days and 23 outpatient visits, and 13% had moved into special housing. There were significant variations between hospitals in levels of health outcomes achieved and resources used after adjusting for case mix. Conclusion Differences in health outcomes and resource use between hospitals were substantial and not entirely explained by differences in patient mix, indicating tendencies of unequal stroke care in Sweden. Healthcare organisation of regions and other structural features could potentially explain parts of the differences identified.</p>},
  articleno    = {e015244},
  author       = {Lekander, Ingrid and Willers, Carl and Ekstrand, Elisabeth and Von Euler, Mia and Fagervall-Yttling, Birgitta and Henricson, Lena and Kostulas, Konstantinos and Lilja, Mikael and Sunnerhagen, Katharina S. and Teichert, Jörg and Pessah-Rasmussen, Hélène},
  issn         = {2044-6055},
  keyword      = {case-mix adjustment,health outcomes,inequalities,resource use,value-based healthcare},
  language     = {eng},
  month        = {09},
  number       = {9},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Hospital comparison of stroke care in Sweden : A register-based study},
  url          = {http://dx.doi.org/10.1136/bmjopen-2016-015244},
  volume       = {7},
  year         = {2017},
}