Article

This study examined whether age disparities existed across postdischarge quality
indicators (QIs) for veterans with ischemic stroke who received care at
Department of Veterans Affairs medical centers (VAMCs). This retrospective cohort
included a national sample of 3,196 veterans who were diagnosed with ischemic
stroke and received acute and postdischarge stroke care at 127 VAMCs in fiscal
year 2007 (10/1/06 through 9/30/07). Data included an assessment of postdischarge
stroke QIs in the outpatient setting during the 6 mo postdischarge. The QIs
included measurement of and goal achievement for (1) blood pressure, (2) serum
international normalized ratio (INR) for all patients discharged on warfarin, (3)
cholesterol (low-density lipoprotein [LDL]) levels, (4) serum glycosylated
hemoglobin, and (5) depression treatment. The mean age for the 3,196 veterans
included in this study was 67.2 +/- 11.3 yr. Before risk adjustment, there were
age differences in (1) depression screening/treatment, (2) blood pressure goals,
and (3) LDL levels. After we adjusted for patient sociodemographic, clinical, and
facility-level characteristics by using hierarchical linear mixed modeling, none
of these differences remained significant but INR goals for patients discharged
on warfarin differed significantly by age. After we adjusted for patient and
facility characteristics, fewer age differences were found in the postdischarge
stroke QIs. Clinical trial registration was not required.

Langue : ANGLAIS