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Effect of the coronavirus disease 2019 pandemic on the quality of stroke care in stroke units and alternative wards : A national comparative analysis
Cadilhac, Dominique A. Kim, Joosup Cloud, Geoffrey Anderson, Craig S. Tod, Emma K. Breen, Sibilah J. Faux, Steven Kleinig, Timothy Castley, Helen Lindley, Richard I.
Cadilhac, Dominique A.
Kim, Joosup
Cloud, Geoffrey
Anderson, Craig S.
Tod, Emma K.
Breen, Sibilah J.
Faux, Steven
Kleinig, Timothy
Castley, Helen
Lindley, Richard I.
Author
Cadilhac, Dominique A.
Kim, Joosup
Cloud, Geoffrey
Anderson, Craig S.
Tod, Emma K.
Breen, Sibilah J.
Faux, Steven
Kleinig, Timothy
Castley, Helen
Lindley, Richard I.
Middleton, Sandy
Yan, Bernard
Hill, Kelvin
Jones, Brett
Shah, Darshan
Jaques, Katherine
Clissold, Benjamin
Campbell, Bruce
Lannin, Natasha A.
Kim, Joosup
Cloud, Geoffrey
Anderson, Craig S.
Tod, Emma K.
Breen, Sibilah J.
Faux, Steven
Kleinig, Timothy
Castley, Helen
Lindley, Richard I.
Middleton, Sandy
Yan, Bernard
Hill, Kelvin
Jones, Brett
Shah, Darshan
Jaques, Katherine
Clissold, Benjamin
Campbell, Bruce
Lannin, Natasha A.
Abstract
Background and Purpose
Changes to hospital systems were implemented from March 2020 in Australia in response to the coronavirus disease 2019 pandemic, including decreased resources allocated to stroke units. We investigate changes in the quality of acute care for patients with stroke or transient ischemic attack during the pandemic according to patients’ treatment setting (stroke unit or alternate ward).
Methods
We conducted a retrospective cohort study of patients admitted with stroke or transient ischemic attack between January 2019 and June 2020 in the Australian Stroke Clinical Registry (AuSCR). The AuSCR monitors patients’ treatment setting, provision of allied health and nursing interventions, prescription of secondary prevention medications, and discharge destination. Weekly trends in the quality of care before and during the pandemic period were assessed using interrupted time series analyses.
Results
In total, 18,662 patients in 2019 and 8,850 patients in 2020 were included. Overall, 75% were treated in stroke units. Before the pandemic, treatment in a stroke unit was superior to alternate wards for the provision of all evidence-based therapies assessed. During the pandemic period, the proportion of patients receiving a swallow screen or assessment, being discharged to rehabilitation, and being prescribed secondary prevention medications decreased by 0.58% to 1.08% per week in patients treated in other ward settings relative to patients treated in stroke units. This change represented a 9% to 17% increase in the care gap between these treatment settings during the period of the pandemic that was evaluated (16 weeks).
Conclusions
During the first 6 months of the pandemic, widening care disparities between stroke units and alternate wards have occurred.
Keywords
quality of health care, stroke, COVID-19
Date
2022
Type
Journal article
Journal
Journal of Stroke
Book
Volume
24
Issue
1
Page Range
79-87
Article Number
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open