Featured Research

from universities, journals, and other organizations

Most US Hospitals Don't Provide Powerful Acute Stroke Drug To Medicare Patients

Date:
February 19, 2009
Source:
American Heart Association
Summary:
Sixty-four percent of US hospitals did not give Medicare patients approved stroke clot-busters within a recent two-year period. Forty percent of the US population (about 162 million people) live in a county without a hospital that delivers the drug tPA to Medicare patients at (or better than) the national average rate of 2.4 percent. The study is the first to analyze hospital delivery of the drug tPA, but focused only on the Medicare database.

Most U.S. hospitals did not give an approved acute stroke drug to any Medicare patients between 2005 and 2007, and a large portion of the general population does not have ready access to a hospital that provides the treatment to Medicare patients, according to research presented at the American Stroke Association’s International Stroke Conference 2009.

Tissue plasminogen activator (tPA) is a thrombolytic, or clot-busting agent. It’s the only drug approved by the U.S. Food and Drug Administration for the acute (urgent) treatment of ischemic stroke, the most common type of stroke. When given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown to significantly reverse the effects of stroke and reduce permanent disability.

But researchers suspect that a small number of hospitals are responsible for administering the majority of tPA treatment.

“Previously reported national rates for tPA administration have been varied and confusing — from 0 percent to 20 percent,” said Dawn Kleindorfer, M.D., lead author of the study and stroke neurologist and associate professor in the University of Cincinnati College of Medicine in Ohio. “These averaged national rates do not reflect the fact that some hospitals are providing this therapy to patients often; while others not at all. So, we evaluated by hospital to get a clear picture of treatment rates and access.”

The study is the first description of tPA treatment rates by U.S. hospitals using a comprehensive administrative dataset.

Kleindorfer and colleagues reviewed national Medicare claims-based database records for every fee-for-serves Medicare-eligible hospital discharge in the United States. There were 4,750 hospitals in the database, which included 495,186 ischemic stroke admission. The researchers report that, between July 1, 2005 and June 30, 2007, the tPA treatment national average was 2.4 percent of all ischemic stroke patients in the Medicare database.

“We found, unfortunately, that about 64 percent of U.S. hospitals did not give tPA to Medicare patients within the two-year study period,” Kleindorfer said.

Most hospitals that did not give the treatment were small, with an average bed size of 95, but it is unclear how hospital size was a factor. The analysis on how rural location, bed size and other factors influence hospital treatment rate is still being conducted.

Researchers also compared the hospital rates of treatment to the population density by county, and found that 40 percent of the U.S. population resides in a county without a hospital that reached at least the national average or better in tPA treatment. Kleindorfer noted that areas served by hospitals often cross county lines, but it is an overall estimate of public access to tPA- treating hospitals.

“Such nationally-based resource utilization data is important for planning at the local and national levels, especially for telemedicine efforts that can reach underserved areas,” Kleindorfer said. “We’re hoping that this information will be useful to hospital systems all over the country, as they plan to improve patient access to stroke-limiting treatments such as tPA.”

However, researchers acknowledge that the study findings are limited because only Medicare patients were included and may not reflect overall tPA use.

The findings highlight the inadequate use of an important treatment and the need for telemedicine and other approaches to ensure that patients have rapid access to acute stroke care, according to an American Stroke Association national spokesperson.

“This study sheds important light on a major disparity in acute stroke care delivery,” said spokesperson Lee Schwamm, M.D., associated professor of Neurology at Harvard. “Individuals and agencies responsible for the equitable distribution of healthcare resources need to examine these and other data to identify strategies that will provide adequate acute stroke care to all their citizens.

“With recent data suggesting that tPA can be safe and effective when given up until 4.5 hours after stroke onset, the need for broader access is even more crucial.”

Co-authors are: Yingying Xu, Ph.D.; Pooja Khatri, M.D.; Opeolu Adeoye, M.D.; and Richard Hornung, Ph.D. Individual author disclosures can be found on the abstract.

The U.S. Centers for Disease Control and Prevention funded the study.


Story Source:

The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.


Cite This Page:

American Heart Association. "Most US Hospitals Don't Provide Powerful Acute Stroke Drug To Medicare Patients." ScienceDaily. ScienceDaily, 19 February 2009. <www.sciencedaily.com/releases/2009/02/090219202710.htm>.
American Heart Association. (2009, February 19). Most US Hospitals Don't Provide Powerful Acute Stroke Drug To Medicare Patients. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2009/02/090219202710.htm
American Heart Association. "Most US Hospitals Don't Provide Powerful Acute Stroke Drug To Medicare Patients." ScienceDaily. www.sciencedaily.com/releases/2009/02/090219202710.htm (accessed October 20, 2014).

Share This



More Mind & Brain News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Your Birth Season Might Determine Your Temperament

Your Birth Season Might Determine Your Temperament

Newsy (Oct. 20, 2014) A new study says the season you're born in can determine your temperament — and one season has a surprising outcome. Video provided by Newsy
Powered by NewsLook.com
Court Ruling Means Kids' Online Activity Could Be On Parents

Court Ruling Means Kids' Online Activity Could Be On Parents

Newsy (Oct. 17, 2014) In a ruling attorneys for both sides agreed was a first of its kind, a Georgia appeals court said parents can be held liable for what kids put online. Video provided by Newsy
Powered by NewsLook.com
The Best Foods To Boost Your Mood

The Best Foods To Boost Your Mood

Buzz60 (Oct. 17, 2014) Feeling down? Reach for the refrigerator, not the medicine cabinet! TC Newman (@PurpleTCNewman) shares some of the best foods to boost your mood. Video provided by Buzz60
Powered by NewsLook.com
You Can Get Addicted To Google Glass, Apparently

You Can Get Addicted To Google Glass, Apparently

Newsy (Oct. 15, 2014) Researchers claim they’ve diagnosed the first example of the disorder in a 31-year-old U.S. Navy serviceman. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins