Gorelick PB.

J Stroke. 2013 May; 15(2): 78-89.

2013

Hospital

Not applicable

Disease-specific Care

Yes

To discuss the history of organized stroke care in the United States, evidence to support the value of primary and comprehensive stroke centers, and the certification criteria and process to become a primary or comprehensive stroke center.

Not a Study

Stroke center designation has been associated with a number of quality improvements including but not limited to access to timely thrombolytic therapy and utilization of stroke unit care. Primary stroke centers may be established successfully as a metropolitan-wide matrix in large population areas to facilitate diagnosis and treatment of acute stroke patients. Organization of acute stroke in this way may be advantageous especially when there is high annual hospital volume or high physician patient volume in relation to stroke care which heightens preferable outcomes or cost savings. An organized stroke care system such as an inpatient stroke unit has been associated with reduced length of care and case fatality, cost-effectiveness when followed by early supportive discharge, and as a model for stroke care, generalizeability if implemented in non-principal referral hospitals. It should be noted that there is evidence to suggest that primary stroke center designated hospitals had better outcomes than non-certified hospitals before The Joint Commission program for primary stroke center designation was implemented. Possibly, the certified hospitals had organizational programs already in place prior to achieving certification status.

Not Identified

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779669/

comprehensive stroke center, organization of health care, primary stroke center

UTD