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Hospital comparison of stroke care in Sweden: a register-based study
Ivbar Institute AB and Medical Management Center, LIME, Karolinska Institutet, Solna, Sweden.
Ivbar Institute AB and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Department of Health Sciences, Lund University, Lund, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet and Karolinska Institutet Stroke research Network at Södersjukhuset, Stockholm, Sweden.ORCID iD: 0000-0002-3845-8100
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2017 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 7, no 9, article id e015244Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: The objective of this study was to estimate the level of health outcomes and resource use at a hospital level during the first year after a stroke, and to identify any potential differences between hospitals after adjusting for patient characteristics (case mix).

METHOD: Data from several registries were linked on individual level: seven regional patient administrative systems, Swedish Stroke Register, Statistics Sweden, National Board of Health and Welfare and Swedish Social Insurance Agency. The study population consisted of 14 125 patients presenting with a stroke during 2010. Case-mix adjusted analysis of hospital differences was made on five aspects of health outcomes and resource use, 1 year post-stroke.

RESULTS: The results indicated that 26% of patients had died within a year of their stroke. Among those who survived, almost 5% had a recurrent stroke and 40% were left with a disability. On average, the patients had 22 inpatient days and 23 outpatient visits, and 13% had moved into special housing. There were significant variations between hospitals in levels of health outcomes achieved and resources used after adjusting for case mix.

CONCLUSION: Differences in health outcomes and resource use between hospitals were substantial and not entirely explained by differences in patient mix, indicating tendencies of unequal stroke care in Sweden. Healthcare organisation of regions and other structural features could potentially explain parts of the differences identified.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2017. Vol. 7, no 9, article id e015244
Keywords [en]
Case-mix adjustment, health outcomes, inequalities, resource use, value-based healthcare
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Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-80691DOI: 10.1136/bmjopen-2016-015244ISI: 000412650700042PubMedID: 28882906Scopus ID: 2-s2.0-85029112119OAI: oai:DiVA.org:oru-80691DiVA, id: diva2:1414824
Available from: 2020-03-16 Created: 2020-03-16 Last updated: 2024-01-02Bibliographically approved

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