Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/11056
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dc.contributor.authorCadilhac, Dominique Aen
dc.contributor.authorKilkenny, Monique Fen
dc.contributor.authorLongworth, Men
dc.contributor.authorPollack, M R Pen
dc.contributor.authorLevi, Christopher Ren
dc.date.accessioned2015-05-16T00:38:05Z
dc.date.available2015-05-16T00:38:05Z
dc.date.issued2011-04-01en
dc.identifier.citationInternal Medicine Journal; 41(4): 321-6en
dc.identifier.govdoc20546059en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/11056en
dc.description.abstract  Stroke care across Australian hospitals is variable. The impact on health outcomes, in particular levels of disability for patients in rural areas, is unclear. The aim of this study was to determine whether geographic location and access to stroke units are associated with differences in health outcomes in patients with acute stroke.  Retrospective cohort study of consecutive eligible admissions from 32 hospitals (12 rural) in New South Wales between 2003 and 2007. Health status measured at discharge included level of independence (modified Rankin score: mRS) and frequency of severe complications during hospitalization. Multivariable analyses included adjustment for patient casemix and clustering.  Among 2254 eligible patients, 55% were treated in metropolitan hospitals. Stroke unit treatment varied significantly (rural 3%; metropolitan 77%). Age, gender and stroke type did not differ by location (mean age 74, 50% female). After adjusting for age, gender, ethnicity, important risk factors and validated stroke prognostic variables, patients treated in rural hospitals had a greater odds of dying during hospitalization compared with those treated in metropolitan hospitals (adjusted odds ratio (aOR) 1.46, 95% confidence interval (CI) 1.03-2.05). There were no differences in mortality or frequency of severe complications between patients treated in rural and metropolitan hospitals when we adjusted for access to stroke units (aOR 1.00, 95% CI 0.62-1.61). Nevertheless, patients treated in rural hospitals were more dependent (mRS 3-5) at discharge (aOR 1.82, 95% CI 1.23-2.70) despite adjusting for stroke unit status.  Patients with stroke treated in rural hospitals have poorer health outcomes, especially if not managed in stroke units.en
dc.language.isoenen
dc.subject.otherAgeden
dc.subject.otherAged, 80 and overen
dc.subject.otherCohort Studiesen
dc.subject.otherFemaleen
dc.subject.otherHospital Mortality.trendsen
dc.subject.otherHospitalization.trendsen
dc.subject.otherHospitals, Rural.standards.trendsen
dc.subject.otherHospitals, Urban.standards.trendsen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherNew South Wales.epidemiologyen
dc.subject.otherPatient Discharge.standards.trendsen
dc.subject.otherRetrospective Studiesen
dc.subject.otherRisk Factorsen
dc.subject.otherStroke.diagnosis.mortality.therapyen
dc.subject.otherTreatment Outcomeen
dc.titleMetropolitan-rural divide for stroke outcomes: do stroke units make a difference?en
dc.typeJournal Articleen
dc.identifier.journaltitleInternal Medicine Journalen
dc.identifier.affiliationNational Stroke Research Institute, Florey Neuroscience Institutes, Melbourne Brain Centre, Austin Health, 245 Burgundy St, Heidelberg, VIC 3084, Australiaen
dc.identifier.doi10.1111/j.1445-5994.2010.02280.xen
dc.description.pages321-6en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/20546059en
dc.contributor.corpauthorMetropolitan Clinical Taskforce and Stroke Services New South Wales Coordinating Committeeen
dc.type.austinJournal Articleen
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
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