Loading…
Impact of institution of a stroke program upon referral bias at a rural academic medical center
Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose:...
Saved in:
| Published in: | The Journal of rural health 2005-06, Vol.21 (3), p.269-271 |
|---|---|
| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23 |
| container_end_page | 271 |
| container_issue | 3 |
| container_start_page | 269 |
| container_title | The Journal of rural health |
| container_volume | 21 |
| creator | Riggs, J.E Libell, D.P Brooks, C.E Hobbs, G.R |
| description | Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a clinical acute stroke program upon referral bias in August 2000. Methods: A chart review of acute stroke (DRG 14) discharges during 2001 from a rural academic medical center was compared with the same data from 1999. Results: The odds ratio of ICH in hospital-transfer patients compared with nonhospital-transfer patients decreased from 11.7 in 1999 to 3.2 in 2001 (P |
| doi_str_mv | 10.1111/j.1748-0361.2005.tb00094.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68465486</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ericid>EJ693851</ericid><sourcerecordid>68465486</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23</originalsourceid><addsrcrecordid>eNqVkMtu1DAUhi0EotOBN0AQsegu4Ti-xGZRCZXS6aiAVKhAbCzHcSpPk8lgO2L69jjKaFhjL6zj_zu3H6G3GAqczrtNgSsqciAcFyUAK2INAJIW-ydocZSeogUICXnF2c8TdBrCBqCUgtDn6ARzkCUBskDqut9pE7Ohzdw2RBfH6IbtFOosRD882Gznh3uv-2zcJcHb1nqvu6x2OmQ6JsyPU6yNbmzvTNbbxpn0Yew2Wv8CPWt1F-zLw7tEd58uv1-s8puvV9cXH25yQxmTeWsYxq2mlTFW4LqqDWNpVNwYIQ2UNSkNbWhtLAgmNaN1o6ESHCyuDNO2JEt0NtdN0_4ebYiqd8HYrtNbO4xBcUE5o4In8P0MGj-EkNZRO-967R8VBjXZqzZq8lBNHqrJXnWwV-1T8utDl7FOe_5LPfiZgFczYL0zR_lyzSURDCf5fJb_uM4-_kdntb5dlanIEuVzARei3R8LaP-geEUqpn58uVK368_sF1t9VOvEv5n5Vg9K33sX1N23EjABnK7kjPwFlKesuw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68465486</pqid></control><display><type>article</type><title>Impact of institution of a stroke program upon referral bias at a rural academic medical center</title><source>Wiley</source><source>ERIC</source><creator>Riggs, J.E ; Libell, D.P ; Brooks, C.E ; Hobbs, G.R</creator><creatorcontrib>Riggs, J.E ; Libell, D.P ; Brooks, C.E ; Hobbs, G.R</creatorcontrib><description>Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a clinical acute stroke program upon referral bias in August 2000. Methods: A chart review of acute stroke (DRG 14) discharges during 2001 from a rural academic medical center was compared with the same data from 1999. Results: The odds ratio of ICH in hospital-transfer patients compared with nonhospital-transfer patients decreased from 11.7 in 1999 to 3.2 in 2001 (P<.035). Conclusions: This study demonstrated the rapid magnitude and significance that clinical programs can have upon referral bias. Changes in referral bias may be more rapid at rural academic medical centers because of the relative lack of health care delivery competition.</description><identifier>ISSN: 0890-765X</identifier><identifier>EISSN: 1748-0361</identifier><identifier>DOI: 10.1111/j.1748-0361.2005.tb00094.x</identifier><identifier>PMID: 16092303</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Academic Medical Centers - standards ; Academic Medical Centers - utilization ; Cerebral Hemorrhage - classification ; Cerebral Hemorrhage - mortality ; Cerebral Hemorrhage - therapy ; Diagnosis-Related Groups ; Hospital Mortality ; Hospitals, Rural - standards ; Hospitals, Rural - utilization ; Humans ; intracerebral hemorrhage (ICH) ; Medical Education ; mortality ; Mortality Rate ; Odds Ratio ; Patient Transfer - statistics & numerical data ; Patients ; Program Effectiveness ; Program Evaluation ; Referral ; Referral and Consultation - statistics & numerical data ; Risk Assessment ; rural health ; rural hospitals ; Selection Bias ; Severity of Illness Index ; stroke ; Stroke - classification ; Stroke - mortality ; Stroke - therapy ; West Virginia - epidemiology</subject><ispartof>The Journal of rural health, 2005-06, Vol.21 (3), p.269-271</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23</citedby><cites>FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ693851$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16092303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Riggs, J.E</creatorcontrib><creatorcontrib>Libell, D.P</creatorcontrib><creatorcontrib>Brooks, C.E</creatorcontrib><creatorcontrib>Hobbs, G.R</creatorcontrib><title>Impact of institution of a stroke program upon referral bias at a rural academic medical center</title><title>The Journal of rural health</title><addtitle>J Rural Health</addtitle><description>Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a clinical acute stroke program upon referral bias in August 2000. Methods: A chart review of acute stroke (DRG 14) discharges during 2001 from a rural academic medical center was compared with the same data from 1999. Results: The odds ratio of ICH in hospital-transfer patients compared with nonhospital-transfer patients decreased from 11.7 in 1999 to 3.2 in 2001 (P<.035). Conclusions: This study demonstrated the rapid magnitude and significance that clinical programs can have upon referral bias. Changes in referral bias may be more rapid at rural academic medical centers because of the relative lack of health care delivery competition.</description><subject>Academic Medical Centers - standards</subject><subject>Academic Medical Centers - utilization</subject><subject>Cerebral Hemorrhage - classification</subject><subject>Cerebral Hemorrhage - mortality</subject><subject>Cerebral Hemorrhage - therapy</subject><subject>Diagnosis-Related Groups</subject><subject>Hospital Mortality</subject><subject>Hospitals, Rural - standards</subject><subject>Hospitals, Rural - utilization</subject><subject>Humans</subject><subject>intracerebral hemorrhage (ICH)</subject><subject>Medical Education</subject><subject>mortality</subject><subject>Mortality Rate</subject><subject>Odds Ratio</subject><subject>Patient Transfer - statistics & numerical data</subject><subject>Patients</subject><subject>Program Effectiveness</subject><subject>Program Evaluation</subject><subject>Referral</subject><subject>Referral and Consultation - statistics & numerical data</subject><subject>Risk Assessment</subject><subject>rural health</subject><subject>rural hospitals</subject><subject>Selection Bias</subject><subject>Severity of Illness Index</subject><subject>stroke</subject><subject>Stroke - classification</subject><subject>Stroke - mortality</subject><subject>Stroke - therapy</subject><subject>West Virginia - epidemiology</subject><issn>0890-765X</issn><issn>1748-0361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>7SW</sourceid><recordid>eNqVkMtu1DAUhi0EotOBN0AQsegu4Ti-xGZRCZXS6aiAVKhAbCzHcSpPk8lgO2L69jjKaFhjL6zj_zu3H6G3GAqczrtNgSsqciAcFyUAK2INAJIW-ydocZSeogUICXnF2c8TdBrCBqCUgtDn6ARzkCUBskDqut9pE7Ohzdw2RBfH6IbtFOosRD882Gznh3uv-2zcJcHb1nqvu6x2OmQ6JsyPU6yNbmzvTNbbxpn0Yew2Wv8CPWt1F-zLw7tEd58uv1-s8puvV9cXH25yQxmTeWsYxq2mlTFW4LqqDWNpVNwYIQ2UNSkNbWhtLAgmNaN1o6ESHCyuDNO2JEt0NtdN0_4ebYiqd8HYrtNbO4xBcUE5o4In8P0MGj-EkNZRO-967R8VBjXZqzZq8lBNHqrJXnWwV-1T8utDl7FOe_5LPfiZgFczYL0zR_lyzSURDCf5fJb_uM4-_kdntb5dlanIEuVzARei3R8LaP-geEUqpn58uVK368_sF1t9VOvEv5n5Vg9K33sX1N23EjABnK7kjPwFlKesuw</recordid><startdate>200506</startdate><enddate>200506</enddate><creator>Riggs, J.E</creator><creator>Libell, D.P</creator><creator>Brooks, C.E</creator><creator>Hobbs, G.R</creator><general>Blackwell Publishing Ltd</general><general>National Rural Health Association, One West Armour Blvd, Suite 203, Kansas City, Missouri</general><scope>FBQ</scope><scope>BSCLL</scope><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200506</creationdate><title>Impact of institution of a stroke program upon referral bias at a rural academic medical center</title><author>Riggs, J.E ; Libell, D.P ; Brooks, C.E ; Hobbs, G.R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Academic Medical Centers - standards</topic><topic>Academic Medical Centers - utilization</topic><topic>Cerebral Hemorrhage - classification</topic><topic>Cerebral Hemorrhage - mortality</topic><topic>Cerebral Hemorrhage - therapy</topic><topic>Diagnosis-Related Groups</topic><topic>Hospital Mortality</topic><topic>Hospitals, Rural - standards</topic><topic>Hospitals, Rural - utilization</topic><topic>Humans</topic><topic>intracerebral hemorrhage (ICH)</topic><topic>Medical Education</topic><topic>mortality</topic><topic>Mortality Rate</topic><topic>Odds Ratio</topic><topic>Patient Transfer - statistics & numerical data</topic><topic>Patients</topic><topic>Program Effectiveness</topic><topic>Program Evaluation</topic><topic>Referral</topic><topic>Referral and Consultation - statistics & numerical data</topic><topic>Risk Assessment</topic><topic>rural health</topic><topic>rural hospitals</topic><topic>Selection Bias</topic><topic>Severity of Illness Index</topic><topic>stroke</topic><topic>Stroke - classification</topic><topic>Stroke - mortality</topic><topic>Stroke - therapy</topic><topic>West Virginia - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Riggs, J.E</creatorcontrib><creatorcontrib>Libell, D.P</creatorcontrib><creatorcontrib>Brooks, C.E</creatorcontrib><creatorcontrib>Hobbs, G.R</creatorcontrib><collection>AGRIS</collection><collection>Istex</collection><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of rural health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Riggs, J.E</au><au>Libell, D.P</au><au>Brooks, C.E</au><au>Hobbs, G.R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ693851</ericid><atitle>Impact of institution of a stroke program upon referral bias at a rural academic medical center</atitle><jtitle>The Journal of rural health</jtitle><addtitle>J Rural Health</addtitle><date>2005-06</date><risdate>2005</risdate><volume>21</volume><issue>3</issue><spage>269</spage><epage>271</epage><pages>269-271</pages><issn>0890-765X</issn><eissn>1748-0361</eissn><abstract>Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a clinical acute stroke program upon referral bias in August 2000. Methods: A chart review of acute stroke (DRG 14) discharges during 2001 from a rural academic medical center was compared with the same data from 1999. Results: The odds ratio of ICH in hospital-transfer patients compared with nonhospital-transfer patients decreased from 11.7 in 1999 to 3.2 in 2001 (P<.035). Conclusions: This study demonstrated the rapid magnitude and significance that clinical programs can have upon referral bias. Changes in referral bias may be more rapid at rural academic medical centers because of the relative lack of health care delivery competition.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>16092303</pmid><doi>10.1111/j.1748-0361.2005.tb00094.x</doi><tpages>3</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0890-765X |
| ispartof | The Journal of rural health, 2005-06, Vol.21 (3), p.269-271 |
| issn | 0890-765X 1748-0361 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68465486 |
| source | Wiley; ERIC |
| subjects | Academic Medical Centers - standards Academic Medical Centers - utilization Cerebral Hemorrhage - classification Cerebral Hemorrhage - mortality Cerebral Hemorrhage - therapy Diagnosis-Related Groups Hospital Mortality Hospitals, Rural - standards Hospitals, Rural - utilization Humans intracerebral hemorrhage (ICH) Medical Education mortality Mortality Rate Odds Ratio Patient Transfer - statistics & numerical data Patients Program Effectiveness Program Evaluation Referral Referral and Consultation - statistics & numerical data Risk Assessment rural health rural hospitals Selection Bias Severity of Illness Index stroke Stroke - classification Stroke - mortality Stroke - therapy West Virginia - epidemiology |
| title | Impact of institution of a stroke program upon referral bias at a rural academic medical center |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T14%3A50%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20institution%20of%20a%20stroke%20program%20upon%20referral%20bias%20at%20a%20rural%20academic%20medical%20center&rft.jtitle=The%20Journal%20of%20rural%20health&rft.au=Riggs,%20J.E&rft.date=2005-06&rft.volume=21&rft.issue=3&rft.spage=269&rft.epage=271&rft.pages=269-271&rft.issn=0890-765X&rft.eissn=1748-0361&rft_id=info:doi/10.1111/j.1748-0361.2005.tb00094.x&rft_dat=%3Cproquest_cross%3E68465486%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4559-fc511fa47cce81b7bc558341dc89c02b32c4d4bce0859a54bda07860e17c5ae23%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=68465486&rft_id=info:pmid/16092303&rft_ericid=EJ693851&rfr_iscdi=true |