Table 2.
Association between factors related with the quality of care and case fatality rate of acute ischemic stroke in logistic regression at the hospital-level and hospital service area-level
| Variables | Hospital-level (n = 262) |
Hospital service area-level (n = 64) |
||
|---|---|---|---|---|
| OR (95% CI) | aOR (95% CI)1 | OR (95% CI) | aOR (95% CI)1 | |
| Structure factors2 | ||||
| Stroke unit | 0.81 (0.77, 0.85) | 0.90 (0.86, 0.95) | 0.83 (0.79, 0.88) | 0.93 (0.87, 1.00) |
| Stroke specialists3 | 0.67 (0.62, 0.72) | 0.86 (0.79, 0.94) | 0.58 (0.49, 0.68) | 0.83 (0.69, 0.99) |
| Process factors2 | ||||
| Missing NIHSS | 1.01 (1.01, 1.01) | 1.01 (1.01, 1.01) | 1.01 (1.01, 1.01) | 1.01 (1.01, 1.01) |
| Using IV-tPA | 0.99 (0.98, 1.00) | 1.00 (0.99, 1.01) | 1.00 (0.99, 1.00) | 1.00 (0.99, 1.01) |
| Using EVT | 0.97 (0.96, 0.98) | 0.98 (0.98, 0.99) | 0.95 (0.97, 0.99) | 0.98 (0.97, 0.99) |
| Classification of hospitals by annual procedure of EVT | ||||
| 0 | 1.00 (reference) | 1.00 (reference) | - | - |
| 1-14 | 0.74 (0.69, 0.80) | 0.97 (0.88, 1.06) | - | - |
| ≥15 | 0.64 (0.56, 0.65) | 0.82 (0.75, 0.90) | - | - |
| Structure and process factors | ||||
| TSC4 | - | - | 0.82 (0.79, 0.87) | 0.90 (0.86, 0.95) |
OR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; NIHSS, National Institute of Health Stroke Scale; IV-tPA, intravenous-recombinant tissue plasminogen activator; EVT, endovascular thrombectomy; TSC, thrombectomy-capable center.
Adjusted for average age, percentage of men, and average NIHSS.
According to Donabedian’s theoretical framework for quality of healthcare.
Stroke specialists are physicians with special skills in stroke such as neurology, neurosurgery, and rehabilitation medicine.
TSC is defined with the presence of stroke unit, the presence of stroke specialists, and performing more than 15 EVT procedures per year according to the criteria of TSC in Joint Commission.