Stroke Care in an Australian Rural Private Health Care Setting

Nirosen Vijiaratnam^1,2*, Bernard Yan³, Pamela Anjara², Thomas Kraemer¹, Mandy Lau¹, Brett Knight¹

¹St. John of God Hospital, Ballarat, Australia.
²Western Health, Melbourne, Australia.
³Melbourne Health, Melbourne, Australia.

DOI: 10.4236/wjns.2015.51002                

Abstract

Stroke is a leading cause of disability and death in Australia. There is a clear benefit in caring for stroke patients in stroke care units. Access to these centres is limited particularly in the rural setting. Certified stroke care units in the private health care setting are also unheard of. The superiority of these units is thought to be due to better adherence to processes of care (early utility of CT scan, allied health input within 24 hours, neurological observations, DVT prophylaxis and appropriate use of antiplatelet and anticoagulant use). We audited care of 100 patients who presented to the St. John of God Hospital (rural private hospital) over a period of 3 years. This included baseline demographics, adherence of processes of care, utility of appropriate investigations, and outcome measures such as discharge destination, level of function at discharge and complication rates. These data were compared with the national stroke report (AuSCR) and adherence to processes of care was compared with the SCOPE study (the first study to establish the benefit of POC). When compared with data from the AuSCR national report 2012, we found a higher mortality rate, an increased rate of disability on discharge, and a mixed adherence to processes of care. We also found a significant proportion of patients (40%) who were eligible to receive thrombolysis but did not. Overall we found that there were significant strengths to be drawn upon in the rural private healthcare setting and a more organised approach could improve outcomes.

Keywords

Stroke, Outcomes, Processes of Care, Stroke Care Units, Rural Private Healthcare

Conflicts of Interest

The authors declare no conflicts of interest.

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