Abstract 3453: Eliminating Care Disparities: Does Evidence Based Practice Really Work?

Abstract

Background: Disparities in stroke care have been documented throughout the U.S. Major metropolitans, rural, and academic centers alike have uncovered and experienced care disparities. Interventions that may mitigate disparities have been referenced by the Institutes of Medicine and are readily available. Yet, care inequities continue. The question remains: to what extent does evidence-based practice (EBP) eliminate care disparities. Methods: The medical records of 1100 cases from 2010 were reviewed. Mortality, thrombolytic administration, and length of stay (los) were regressed against SES, controlling for EBP and stroke type. Results: Typically reported disparities in mortality, thrombolytic administration, los, and stroke core measures were not found for patients whose care was governed by EBP. The sole exception was a slight increase in los for African Americans, which may not be indicative of care inequities but other conditions such as severity or social support. . Core measures compliance was significantly related to MD specialty, for non-stroke physicians (p> 0.002, coef= -0.04). This is consistent with evidence- based practice literature and literature documenting cohorting of patients to practitioners who have greater disease specific experience. Conclusions: Outcomes differences did not exist across differing socio-economic strata, when use of evidence based practice was controlled for