Exploring the impact of intravenous thrombolysis on length of stay for acute ischemic stroke: a retrospective cohort study.

Abstract:

BACKGROUND:Understanding the factors that influence the hospital length of stay (LOS) for patients with stroke will help in discharge planning and stroke unit management. We explored how intravenous thrombolysis (IVT) affects LOS in an acute-care hospital setting. METHODS:We analyzed adult patients with ischemic stroke who presented within 48 h of onset from a hospital-based stroke registry. The relationship between IVT and prolonged LOS (LOS ≥ 7 days) was studied by both multivariate logistic regression and the classification and regression tree (CART) analyses. RESULTS:Among the study population of 3054 patients, 1110 presented within 4.5 h. The median LOS (interquartile range) was 7 (4 to 11) days, and 1619 patients had prolonged LOS. Multivariate logistic regression revealed that IVT (odds ratio, 0.53; 95 % confidence interval 0.38-0.74) was an independent factor that reduced the risk of prolonged LOS, whereas age, National Institutes of Health Stroke Scale (NIHSS) score, diabetes mellitus, and leukocytosis at admission predicted prolonged LOS. CART analysis identified 4 variables (NIHSS score, IVT, leukocytosis at admission, and age) as important factors to partition the patients into six subgroups. The patient subgroup that had an NIHSS score of 5 to 7 and received IVT had the lowest probability (19 %) of prolonged LOS. CONCLUSIONS:IVT reduced the risk of prolonged LOS in patients with acute ischemic stroke. Measures to increase the rate of IVT are encouraged.

journal_name

BMC Health Serv Res

authors

Hung LC,Hu YH,Sung SF

doi

10.1186/s12913-015-1080-0

subject

Has Abstract

pub_date

2015-09-23 00:00:00

pages

404

issn

1472-6963

pii

10.1186/s12913-015-1080-0

journal_volume

15

pub_type

杂志文章
  • Developing family rooms in mental health inpatient units: an exploratory descriptive study.

    abstract:BACKGROUND:Family-friendly spaces for children and families to visit inpatient mental health units are recommended in international mental health guidelines as one way to provide service delivery that is responsive to the needs of parent-consumers and families. There is a lack of evidence on the implementation of famil...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-015-0914-0

    authors: Isobel S,Foster K,Edwards C

    更新日期:2015-06-19 00:00:00

  • Decomposition of the drivers of the U.S. hospital spending growth, 2001-2009.

    abstract:BACKGROUND:United States health care spending rose rapidly in the 2000s, after a period of temporary slowdown in the 1990s. However, the description of the overall trend and the understanding of the underlying drivers of this trend are very limited. This study investigates how well historical hospital cost/revenue driv...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-14-230

    authors: Wu VY,Shen YC,Yun MS,Melnick G

    更新日期:2014-05-21 00:00:00

  • What questions do patients undergoing lower extremity joint replacement surgery have?

    abstract:BACKGROUND:The value of the Internet to deliver preoperative education would increase if there was variability in questions patients want answered. This study's goal was to have patients consulting an orthopedic surgeon about undergoing either a total hip arthroplasty (THA) or a total knee arthroplasty (TKA) rate the i...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-3-11

    authors: Macario A,Schilling P,Rubio R,Bhalla A,Goodman S

    更新日期:2003-06-24 00:00:00

  • Who are the ostomy patients and caregivers attending Portuguese community pharmacies? A cross-sectional study.

    abstract:BACKGROUND:In 2017, ostomy patients gained access to ostomy products in community pharmacies that are fully reimbursed by the Portuguese National Health Service. This impacted the daily lives of people with ostomy and opened a new market of products and services for pharmacies. However, little is known about the sociod...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-020-05765-7

    authors: Romão M,Figueira D,Galante H,Guerreiro J,Romano S

    更新日期:2020-10-02 00:00:00

  • A comparison between the APACHE II and Charlson Index Score for predicting hospital mortality in critically ill patients.

    abstract:BACKGROUND:Risk adjustment and mortality prediction in studies of critical care are usually performed using acuity of illness scores, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), which emphasize physiological derangement. Common risk adjustment systems used in administrative datasets, like the...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-9-129

    authors: Quach S,Hennessy DA,Faris P,Fong A,Quan H,Doig C

    更新日期:2009-07-30 00:00:00

  • At the interface of community and healthcare systems: a longitudinal cohort study on evolving health and the impact of primary healthcare from the patient's perspective.

    abstract:BACKGROUND:Massive efforts in Canada have been made to renew primary healthcare. However, although early evaluations of initiatives and research on certain aspects of the reform are promising, none have examined the link between patient assessments of care and health outcomes or the impacts at a population level. The g...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-10-258

    authors: Haggerty J,Fortin M,Beaulieu MD,Hudon C,Loignon C,Préville M,Roberge D

    更新日期:2010-09-03 00:00:00

  • Reducing hospital admissions in older care home residents: a 4-year evaluation of the care home innovation Programme (CHIP).

    abstract:BACKGROUND:Older care home residents frequently attend emergency departments with a high conversion to admissions. For this purpose, a novel Care Home Innovation Programme (CHIP) was introduced with the aim of reducing potentially avoidable hospital admissions by 30%. The aim of this study is to evaluate the implementa...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-020-4945-9

    authors: Giebel C,Harvey D,Akpan A,Chamberlain P

    更新日期:2020-02-06 00:00:00

  • Assessing participation in a community-based health planning and services programme in Ghana.

    abstract:BACKGROUND:Community participation is increasingly seen as a pre-requisite for successful health service uptake. It is notoriously difficult to assess participation and little has been done to advance tools for the assessment of community participation. In this paper we illustrate an approach that combines a 'social ps...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-13-233

    authors: Baatiema L,Skovdal M,Rifkin S,Campbell C

    更新日期:2013-06-26 00:00:00

  • Patients' socioeconomic status and their evaluations of primary care in Hong Kong.

    abstract:BACKGROUND:Strengthening primary care is key to Hong Kong's ongoing health system reform. Primary care remains unregulated, private sector dominated and financed mainly out-of-pocket. This study sought to examine the association between patients' socioeconomic status (SES), source of health payments and the quality of ...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-13-487

    authors: Owolabi O,Zhang Z,Wei X,Yang N,Li H,Wong SY,Wong MC,Yip W,Griffiths SM

    更新日期:2013-11-25 00:00:00

  • Health literacy and primary health care use of ethnic minorities in the Netherlands.

    abstract:BACKGROUND:In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations between health literacy and...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-017-2276-2

    authors: van der Gaag M,van der Heide I,Spreeuwenberg PMM,Brabers AEM,Rademakers JJDJM

    更新日期:2017-05-15 00:00:00

  • Strengthening health systems capacity to monitor and evaluate programmes targeted at reducing abortion-related maternal mortality in Jessore district, Bangladesh.

    abstract:BACKGROUND:Abortion related deaths as a proportion of maternal mortality appears to have fallen dramatically in Bangladesh from 5 % in 2001 to 1 % in 2010. Yet complications from menstrual regulation (MR) and unsafe abortion continue to cause deleterious health, economic and social consequences for women in the country...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-015-1115-6

    authors: Huda FA,Ahmed A,Ford ER,Johnston HB

    更新日期:2015-09-28 00:00:00

  • Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain.

    abstract:BACKGROUND:The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the ...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-6-138

    authors: Calderón C,Rotaeche R,Etxebarria A,Marzo M,Rico R,Barandiaran M

    更新日期:2006-10-23 00:00:00

  • Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: systematic review.

    abstract:BACKGROUND:The involvement of mental health service users and their caregivers in health system policy and planning, service monitoring and research can contribute to mental health system strengthening, but as yet there have been very few efforts to do so in low- and middle-income countries (LMICs). METHODS:This syste...

    journal_title:BMC health services research

    pub_type: 杂志文章,评审

    doi:10.1186/s12913-016-1323-8

    authors: Semrau M,Lempp H,Keynejad R,Evans-Lacko S,Mugisha J,Raja S,Lamichhane J,Alem A,Thornicroft G,Hanlon C

    更新日期:2016-03-01 00:00:00

  • Reflecting on "Marketing communications in health and medicine: perspectives from Willis-Knighton Health System": understanding the big picture.

    abstract:BACKGROUND:Willis-Knighton Health System's special supplement in BMC Health Services Research, "Marketing communications in health and medicine: perspectives from Willis-Knighton Health System," focuses on advertising, public relations, sales promotion, and related communicative avenues, associated theory, and more. Ac...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-020-05607-6

    authors: Elrod JK,Fortenberry JL Jr

    更新日期:2020-09-15 00:00:00

  • The cost of hospital-acquired complications for older people with and without dementia; a retrospective cohort study.

    abstract:BACKGROUND:Increased length of stay and high rates of adverse clinical events in hospitalised patients with dementia is stimulating interest and debate about which costs may be associated and potentially avoided within this population. METHODS:A retrospective cohort study was designed to identify and compare estimated...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-015-0743-1

    authors: Bail K,Goss J,Draper B,Berry H,Karmel R,Gibson D

    更新日期:2015-03-08 00:00:00

  • Managing daily surgery schedules in a teaching hospital: a mixed-integer optimization approach.

    abstract:BACKGROUND:This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals pl...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-14-464

    authors: Pulido R,Aguirre AM,Ortega-Mier M,García-Sánchez Á,Méndez CA

    更新日期:2014-10-15 00:00:00

  • A population-based analysis of leaving the hospital against medical advice: incidence and associated variables.

    abstract:BACKGROUND:Prior studies of patients leaving hospital against medical advice (AMA) have been limited by not being population-based or assessing only one type of patient. METHODS:We used administrative data at the Manitoba Centre for Health Policy to evaluate all adult residents of Manitoba, Canada discharged alive fro...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-13-415

    authors: Kraut A,Fransoo R,Olafson K,Ramsey CD,Yogendran M,Garland A

    更新日期:2013-10-14 00:00:00

  • Barriers to and facilitators of the development and utilization of context appropriate evidence based clinical algorithms to optimize clinical care and patient outcomes in the Tikur Anbessa emergency department: a multi-component qualitative study.

    abstract:BACKGROUND:Evidence-based clinical algorithms (EBCA) are knowledge tools to promote evidence use by codifying evidence into action plans to facilitate appropriate care. However, their impact on process and outcomes of care varies considerably across practice settings and providers, highlighting the need for tailoring o...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-019-4008-2

    authors: Puchalski Ritchie LM,Debebe F,Azazh A

    更新日期:2019-03-20 00:00:00

  • Obesity prevention and the role of hospital and community-based health services: a scoping review.

    abstract:BACKGROUND:Control of obesity is an important priority to reduce the burden of chronic disease. Clinical guidelines focus on the role of primary healthcare in obesity prevention. The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based healt...

    journal_title:BMC health services research

    pub_type: 杂志文章,评审

    doi:10.1186/s12913-019-4262-3

    authors: Pearce C,Rychetnik L,Wutzke S,Wilson A

    更新日期:2019-07-05 00:00:00

  • Improving access to medicines for non-communicable diseases in rural India: a mixed methods study protocol using quasi-experimental design.

    abstract:BACKGROUND:India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially ...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-016-1680-3

    authors: Prashanth NS,Elias MA,Pati MK,Aivalli P,Munegowda CM,Bhanuprakash S,Sadhana SM,Criel B,Bigdeli M,Devadasan N

    更新日期:2016-08-22 00:00:00

  • Profile of children referred to primary health care physiotherapy: a longitudinal observational study in Norway.

    abstract:BACKGROUND:Physiotherapy services are an important part of the primary health care services for children, serving a broad spectrum of children referred from different sources and for a variety of reasons. There is limited knowledge about their characteristics and outcome. The aim of this study was to describe the profi...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-020-05988-8

    authors: Evensen KAI,Sellæg S,Stræte AC,Hansen AE,Meisingset I

    更新日期:2021-01-06 00:00:00

  • The experiences of districts in implementing a national incentive programme to promote safe delivery in Nepal.

    abstract:BACKGROUND:Nepal's Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-9-97

    authors: Powell-Jackson T,Morrison J,Tiwari S,Neupane BD,Costello AM

    更新日期:2009-06-09 00:00:00

  • Does one workshop on respecting cultural differences increase health professionals' confidence to improve the care of Australian Aboriginal patients with cancer? An evaluation.

    abstract:BACKGROUND:Aboriginal Australians have worse cancer survival rates than other Australians. Reasons include fear of a cancer diagnosis, reluctance to attend mainstream health services and discrimination from health professionals. Offering health professionals education in care focusing on Aboriginal patients' needs is i...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-017-2599-z

    authors: Durey A,Halkett G,Berg M,Lester L,Kickett M

    更新日期:2017-09-15 00:00:00

  • Assessing key cost drivers associated with caring for chronic kidney disease patients.

    abstract:BACKGROUND:To examine key factors influencing chronic kidney disease (CKD) patients' total expenditure and offer recommendations on how to reduce total cost of CKD care without compromising quality. METHODS:Using the 2002-2011 Medical Expenditure Panel Survey (MEPS) data, our cross-sectional study analyzed 197 patient...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-016-1922-4

    authors: Damien P,Lanham HJ,Parthasarathy M,Shah NL

    更新日期:2016-12-28 00:00:00

  • Gender and social geography: impact on Lady Health Workers mobility in Pakistan.

    abstract:BACKGROUND:In Pakistan, where gendered norms restrict women's mobility, female community health workers (CHWs) provide doorstep primary health services to home-bound women. The program has not achieved optimal functioning. One reason, I argue, may be that the CHWs are unable to make home visits because they have to ope...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-12-360

    authors: Mumtaz Z

    更新日期:2012-10-16 00:00:00

  • The impact of different benefit packages of Medical Financial Assistance Scheme on health service utilization of poor population in rural China.

    abstract:BACKGROUND:Since 2003 and 2005, National Pilot Medical Financial Assistance Scheme (MFA) has been implemented in rural and urban areas of China to improve the poorest families' accessibility to health services. Local governments of the pilot areas formulated various benefit packages. Comparative evaluation research on ...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-10-170

    authors: Hao Y,Wu Q,Zhang Z,Gao L,Ning N,Jiao M,Zakus D

    更新日期:2010-06-17 00:00:00

  • The magnitude and factors associated with delays in management of smear positive tuberculosis in Dar es Salaam, Tanzania.

    abstract:OBJECTIVE:To assess the magnitude and factors responsible for delay in TB management. DESIGN:A cross sectional hospital based survey in Dar es Salaam region, May 2006. RESULTS:We interviewed 639 TB patients. A total of 78.4% of patients had good knowledge on TB transmission. Only 35.9% had good knowledge on the sympt...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/1472-6963-8-158

    authors: Mfinanga SG,Mutayoba BK,Kahwa A,Kimaro G,Mtandu R,Ngadaya E,Egwaga S,Kitua AY

    更新日期:2008-07-27 00:00:00

  • A complex culturally targeted intervention to reduce Hispanic disparities in living kidney donor transplantation: an effectiveness-implementation hybrid study protocol.

    abstract:BACKGROUND:The shortage of organs for kidney transplantation for patients with end-stage renal disease (ESRD) is magnified in Hispanics/Latin Americans in the United States. Living donor kidney transplantation (LDKT) is the treatment of choice for ESRD. However, compared to their representation on the transplant waitli...

    journal_title:BMC health services research

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s12913-018-3151-5

    authors: Gordon EJ,Lee J,Kang RH,Caicedo JC,Holl JL,Ladner DP,Shumate MD

    更新日期:2018-05-16 00:00:00

  • A cross sectional observational study of research activity of allied health teams: is there a link with self-reported success, motivators and barriers to undertaking research?

    abstract:BACKGROUND:Team-based approaches to research capacity building (RCB) may be an efficient means to promote allied health research participation and activity. In order to tailor such interventions, a clearer understanding of current patterns of research participation within allied health teams is needed. Different self-r...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-017-1996-7

    authors: Wenke RJ,Mickan S,Bisset L

    更新日期:2017-02-06 00:00:00

  • Service provision in the wake of a new funding model for community pharmacy.

    abstract:BACKGROUND:Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered i...

    journal_title:BMC health services research

    pub_type: 杂志文章

    doi:10.1186/s12913-018-3120-z

    authors: Smith AJ,Scahill SL,Harrison J,Carroll T,Medlicott NJ

    更新日期:2018-05-02 00:00:00