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This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM.

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Presentation on theme: "This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM."— Presentation transcript:

1 This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM. Postdischarge quality of care: Do age disparities exist among Department of Veterans Affairs ischemic stroke patients? J Rehabil Res Dev. 2013;50(2):263–72. http://dx.doi.org/10.1682/JRRD.2011.08.0145 Slideshow Project DOI:10.1682/JRRD.2011.08.0145JSP Postdischarge quality of care: Do age disparities exist among Department of Veterans Affairs ischemic stroke patients? Neale R. Chumbler, PhD; Huanguang Jia; Michael S. Phipps, MD; Xinli Li, PhD; Diana Ordin, MD, MPH; Linda S. Williams, MD; Laura J. Myers, PhD; Dawn M. Bravata, MD

2 This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM. Postdischarge quality of care: Do age disparities exist among Department of Veterans Affairs ischemic stroke patients? J Rehabil Res Dev. 2013;50(2):263–72. http://dx.doi.org/10.1682/JRRD.2011.08.0145 Slideshow Project DOI:10.1682/JRRD.2011.08.0145JSP Aim – Examine whether age disparities exist in postdischarge quality indicators (QIs) for veterans with ischemic stroke who receive care at Department of Veterans Affairs medical centers (VAMCs). Relevance – Some previous studies have found age differences in care processes, but whether these same differences exist in VAMC stroke care is unclear.

3 This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM. Postdischarge quality of care: Do age disparities exist among Department of Veterans Affairs ischemic stroke patients? J Rehabil Res Dev. 2013;50(2):263–72. http://dx.doi.org/10.1682/JRRD.2011.08.0145 Slideshow Project DOI:10.1682/JRRD.2011.08.0145JSP Method Retrospective cohort of 3,196 veterans. – Diagnosed with ischemic stroke. – Received acute and postdischarge stroke care at 127 VAMCs in fiscal year 2007. Assessed postdischarge stroke QIs in outpatient setting over 6 mo: – Blood pressure. – Serum international normalized ratio (INR). – Cholesterol levels. – Serum glycosylated hemoglobin. – Depression treatment.

4 This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM. Postdischarge quality of care: Do age disparities exist among Department of Veterans Affairs ischemic stroke patients? J Rehabil Res Dev. 2013;50(2):263–72. http://dx.doi.org/10.1682/JRRD.2011.08.0145 Slideshow Project DOI:10.1682/JRRD.2011.08.0145JSP Results After adjustment for sociodemographic, clinical, and facility-level characteristics, only postdischarge INR control differed by age. – Substantially higher for veterans 85 and older. Neither unadjusted nor adjusted results demon- strated consistent decrement in quality with increasing age. – Rather, some care processes provided more often to older patients (cholesterol goal achievement) and others provided more often to younger patients (depression treatment and blood pressure goal achievement).

5 This article and any supplementary material should be cited as follows: Chumbler NR, Jia H, Phipps MS, Li X, Ordin D, Williams LS, Myers LJ, Bravata DM. Postdischarge quality of care: Do age disparities exist among Department of Veterans Affairs ischemic stroke patients? J Rehabil Res Dev. 2013;50(2):263–72. http://dx.doi.org/10.1682/JRRD.2011.08.0145 Slideshow Project DOI:10.1682/JRRD.2011.08.0145JSP Conclusion Overall postdischarge quality for ischemic stroke in VAMCs did not vary consistently by age. However, the few differences that emerged should encourage awareness of possible age disparities. Stroke management should be guided by best clinical evidence and guidelines, irrespective of age.


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