Abstract T MP89: A Comparison of Stroke Core Measure Performance Between Comprehensive Stroke Centers and Primary Stroke Centers

Abstract

Objectives: Performance on the eight Stroke Core Measures (SCM) is a major benchmark used to determine how organizations deliver stroke care. We now compare performance on these SCMs between certified Primary Stroke Centers (PSCs) and Comprehensive Stroke Centers (CSCs). Our hypothesis was that CSCs would achieve higher levels of meeting the SCMs compared to PSCs. Methods: We analyzed performance data on the eight SCMs between the 1046 Joint Commission (JC) certified PSCs and 74 JC certified CSCs using data available in 2013. Data were reported by the hospital via a third-party vendor to the JC. Comparisons were performed using Chi-square analyses. Results: Significant differences between CSC and PSC performance, with CSCs performing better, were seen in the following four SCMs: STK-4, thrombolytic therapy administered to eligible patients (CSC compared to PSC, 94.4% vs 84.2%, p = 0.0002); STK-6, discharge on statin (98.1% vs 97%, p = 0.009); STK-8, stroke education (95.2% vs 93.3%, p = 0.003); and STK-10, assessed for rehabilitation (99.7% vs 98.6%, p = 0.0001). For STK-5, antithrombotic Rx by day 2, PSCs performed better than CSCs (98.5% vs 97.9%, p = 0.02). For STK-1, venous thrombosis prophylaxis, STK-2, discharge on antithrombotic therapy, and STK-3, anticoagulation for atrial fibrillation/flutter, the performance rates between PSCs and CSCs was not significantly different (p > 0.25). Conclusions: CSCs performed better than PSCs for 4 SCMs, as well as PSCs for 3 measures, and not as well as PSCs for one SCM. Overall both types of stroke centers met the SCMs in >93% of cases with one exception (thrombolytic therapy at PSCs). Although CSCs see more complex patients than PSCs, they are still able to provide basic care with a high degree of compliance with SCMs.