Table 4.
Performance Measure Conformity by Hospital PAA Recognition and PSC Certification Status: Unadjusted and Adjusted ORs
| Performance Measures | Hospital Status (Reference PAA−/PSC−) | Unadjusted | Adjusted for Patient Factors* | Adjusted for Patient and Hospital Factors* | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| OR | Lower 95% CI | Upper 95% CI | OR | Lower 95% CI | Upper 95% CI | OR | Lower 95% CI | Upper 95% CI | ||
| IV TPA arrived by 2 hours and used to treat by 3 hours | PAA+/PSC+ | 8.55 | 7.30 | 10.02 | 8.52 | 7.27 | 9.99 | 5.62 | 4.80 | 6.59 |
| PAA+/PSC− | 8.02 | 6.79 | 9.47 | 8.01 | 6.78 | 9.46 | 6.34 | 5.37 | 7.47 | |
| PAA−/PSC+ | 1.96 | 1.55 | 2.48 | 1.95 | 1.54 | 2.46 | 1.53 | 1.21 | 1.93 | |
| Early antithrombotic agent | PAA+/PSC+ | 2.11 | 1.84 | 2.41 | 2.06 | 1.80 | 2.35 | 2.26 | 1.95 | 2.62 |
| PAA+/PSC− | 2.47 | 2.16 | 2.82 | 2.49 | 2.16 | 2.87 | 2.50 | 2.15 | 2.90 | |
| PAA−/PSC+ | 1.46 | 1.20 | 1.79 | 1.44 | 1.18 | 1.76 | 1.57 | 1.27 | 1.94 | |
| DVT prophylaxis | PAA+/PSC+ | 3.34 | 2.95 | 3.79 | 3.35 | 2.95 | 3.81 | 2.89 | 2.52 | 3.31 |
| PAA+/PSC− | 3.37 | 2.95 | 3.85 | 3.38 | 2.95 | 3.88 | 3.01 | 2.63 | 3.46 | |
| PAA−/PSC+ | 1.56 | 1.25 | 1.95 | 1.58 | 1.27 | 1.98 | 1.50 | 1.20 | 1.87 | |
| Antithrombotic agent at discharge | PAA+/PSC+ | 3.16 | 2.72 | 3.66 | 2.99 | 2.55 | 3.51 | 2.73 | 2.31 | 3.22 |
| PAA+/PSC− | 2.84 | 2.40 | 3.36 | 2.82 | 2.35 | 3.38 | 2.60 | 2.14 | 3.14 | |
| PAA−/PSC+ | 1.41 | 1.07 | 1.86 | 1.40 | 1.06 | 1.83 | 1.34 | 1.02 | 1.75 | |
| Anticoagulation for atrial fibrillation | PAA+/PSC+ | 4.48 | 3.81 | 5.26 | 4.35 | 3.70 | 5.12 | 3.51 | 2.94 | 4.20 |
| PAA+/PSC− | 4.37 | 3.67 | 5.20 | 4.41 | 3.71 | 5.25 | 3.76 | 3.15 | 4.51 | |
| PAA−/PSC+ | 1.74 | 1.37 | 2.20 | 1.71 | 1.35 | 2.17 | 1.55 | 1.22 | 1.96 | |
| Statin for LDL>100 mg/dL or not documented | PAA+/PSC+ | 3.23 | 2.93 | 3.56 | 3.13 | 2.82 | 3.49 | 2.58 | 2.31 | 2.89 |
| PAA+/PSC− | 3.07 | 2.77 | 3.41 | 3.16 | 2.81 | 3.55 | 2.77 | 2.47 | 3.11 | |
| PAA−/PSC+ | 1.75 | 1.47 | 2.08 | 1.74 | 1.47 | 2.07 | 1.61 | 1.36 | 1.90 | |
| Smoking cessation counseling | PAA+/PSC+ | 4.39 | 3.46 | 5.59 | 4.40 | 3.46 | 5.60 | 3.91 | 2.92 | 5.23 |
| PAA+/PSC− | 4.11 | 3.14 | 5.37 | 4.16 | 3.18 | 5.45 | 3.88 | 2.89 | 5.21 | |
| PAA−/PSC+ | 1.99 | 1.37 | 2.91 | 1.99 | 1.36 | 2.91 | 1.78 | 1.20 | 2.63 | |
| All‐or‐none measure | PAA+/PSC+ | 3.48 | 3.20 | 3.79 | 3.52 | 3.22 | 3.84 | 3.15 | 2.86 | 3.47 |
| PAA+/PSC− | 3.46 | 3.15 | 3.79 | 3.54 | 3.21 | 3.90 | 3.23 | 2.93 | 3.56 | |
| PAA−/PSC+ | 1.75 | 1.51 | 2.03 | 1.78 | 1.53 | 2.08 | 1.72 | 1.47 | 2.00 | |
CAD indicates coronary heart disease; DVT, deep venous thrombosis; IV, intravenous; MI, myocardial infarction; OR, odds ratio; PAA, Performance Achievement Award; PSC, Primary Stroke Center; PVD, peripheral vascular disease; TIA, transient ischemic attack; TPA, tissue‐type plasminogen activator.
Adjusted for age, sex, race, medical history of atrial fibrillation/flutter, prosthetic heart valve, previous stroke/TIA, CAD/prior MI, carotid stenosis, diabetes, PVD, hypertension, smoking, dyslipidemia, and heart failure, arrived at off‐hours (holiday or before 7 am/after 6 pm on Monday to Friday).
Adjusted for patient characteristics and hospital characteristics of region, number of beds, teaching status, annual ischemic stroke volume, and annual IV TPA treatment volume.