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논문 기본 정보

자료유형
학술저널
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Dominique A. Cadilhac (Department of Medicine Monash University Clayton Australia) Joosup Kim (Department of Medicine Monash University Clayton Australia) Geoffrey Cloud (Department of Neuroscience Central Clinical School Monash University Clayton Australia) Craig S. Anderson (Department of Neuroscience Central Clinical School Monash University Clayton Australia) Emma K. Tod (The Florey Institute of Neuroscience and Mental Health University of Melbourne ParkvilleAustralia) Sibilah J. Breen (The Florey Institute of Neuroscience and Mental Health University of Melbourne ParkvilleAustralia) Steven Faux (Department of Rehabilitation Medicine St Vincent’s Hospital Sydney Sydney Australia) Timothy Kleinig (Department of Neurology Royal Adelaide Hospital Adelaide Australia) Helen Castley (Department of Neurology Royal Hobart Hospital Hobart Australia) Richard I. Lindley (Department of Medicine University of Sydney Sydney Australia) Sandy Middleton (Nursing Research Institute Australian Catholic University Sydney Australia) Bernard Yan (Melbourne Brain Centre at the Royal Melbourne HospitalUniversity of MelbourneParkvilleAustralia) Kelvin Hill (Stroke Foundation Melbourne Australia) Brett Jones (Department of Neurology Canberra Hospital Canberra Australia) Darshan Shah (Department of Neurology Gold Coast Hospital and Health Service Southport Australia) Katherine Jaques (Healthcare Improvement Unit Clinical Excellence Queensland Health Brisbane Australia) Benjamin Clissold (The Florey Institute of Neuroscience and Mental Health University of Melbourne ParkvilleAustralia) Natasha A. Lannin (Department of Neuroscience Central Clinical School Monash University Clayton Australia)
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대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제24권 제1호
발행연도
2022.1
수록면
79 - 87 (9page)

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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.

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