TITLE:
Stroke Care in an Australian Rural Private Health Care Setting
AUTHORS:
Nirosen Vijiaratnam, Bernard Yan, Pamela Anjara, Thomas Kraemer, Mandy Lau, Brett Knight
KEYWORDS:
Stroke, Outcomes, Processes of Care, Stroke Care Units, Rural Private Healthcare
JOURNAL NAME:
World Journal of Neuroscience,
Vol.5 No.1,
January
14,
2015
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.