Abstract T P283: A Survey of Certified Stroke Center Medical Directors in the United States

Abstract

Background: Certification of hospitals as advanced primary stroke centers (PSC) and comprehensive stroke centers (CSC) leads to improvements in stroke care. We aimed to characterize the specialization and demographics of programmatic leadership at stroke centers nationwide, and to determine the proportion of programs lead by Vascular Neurologists. Methods: We identified hospitals holding advanced primary stroke center and comprehensive stroke center designation using the Joint Commission, DNV, and HFAP websites as of September 2013. The identity of the stroke center director was obtained by contacting each individual hospital via their website or telephone. Specialization of each director was confirmed using data available from relevant medical subspecialty board. Gender and date of graduation from medical school was obtained from an online physician database (Healthgrades). Results: There were 1167 PSC and 50 CSC hospitals in the United States certified by the JC (N=1121), DNV (67) and HFAP (35). The director, confirmed at 940 of 1217 (77%) centers, was most often a neurologist (N=747, 81%) followed by Emergency Medicine (58), internal medicine (17), radiology (15), neurosurgery (13) and psychiatry (11). Neurologists with added certification in vascular neurology (n=319) made up just over one third of identified certified stroke center directors. Certified stroke center directors were most often male (N=764, 81%) and experienced, with a median year of graduation from medical school of 1990 (IQR 1981-1997). Among vascular neurologists 84% were male and the median year of medical school graduation was 1991 compared to 1988 for non-vascular neurologists (p=0.023 by Mann-Whitney). A higher proportion of Medical Directors in CSCs were board certified in Vascular Neurology (74%). Conclusions: Most certified stroke centers were lead by a neurologist, and a third by Vascular Neurologists. Certified stroke center directors are predominantly male, with over 20 years of post-medical school experience.