Thursday, October 16, 2014

Do stroke patients already in hospital get less treatment?

You'd think that if you're already a hospital patient, you'd get quicker care for an in-hospital stroke vs. having a stroke elsewhere.

Not necessarily, sadly. After years of visiting and sitting with hospital patients, I can see why. You see delays in almost everything. And in a recent Canadian study, it was found that in-hospital stroke patients wait longer for care:
The study results showed that in-hospital patients waited an average of 4.5 hours from the time symptoms were recognized to undergo computed tomography compared with 1.3 hours for patients brought to the ED.
"To me that's a shocking difference," said Dr Saltman.
About 29% of in-hospital stroke patients met the "benchmark" best practice of getting thrombolysis within 90 minutes of symptom onset compared with 72% of patients coming from the community, said Dr Saltman.
In addition, the in-hospital group was less likely to receive thrombolysis (12%) than the group admitted after having a stroke outside the hospital (19%), even if they were eligible for this intervention, she added.
In-hospital patients stayed longer in the hospital (17 days vs 8 days), were more likely to be discharged to a rehabilitation facility (40% vs 32%), and were less likely to be sent home (35% vs 44%).
This speaks volumes for the need for advocates for stroke patients, especially if they are having speech or physical difficulties while in the hospital.

Is it true in the United States? Add your own experiences below.

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