Standardizing Stroke Care to Improve Outcomes and Reduce Costs

Researchers at the University of Michigan Medical School have developed a quilted map of the United States highlighting the tremendous variation in stroke care in need of standardization. Published this month in the journal Stroke, the study points to the huge variation in the use of the "clotbuster" drug tissue plasminogen activator (tPA), which if administered within the first few hours of a stoke can restore blood supply to the brain. This can avoid potential disabilities and lower long-term costs of care in the patients.

The population used in the study were Medicare enrollees who had suffered from a stroke and were admitted through Emergency Rooms in one of 3436 hositals surveyed in the study between 2007 and 2010. In 20% of the geographical regions where these hospitals were located, patients did not receive tPA. Of the 844,241 admissions resulting from ischemic stroke, 3.7% of patients were administered tPA and only 0.5% received intra-arterial stroke treatment, with or without tPA.

A senior author on the study believes understanding the causes of the variation and addressing them would have a significant impact on stroke-associated disability.

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