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Organizing stroke pathways differently – effects on readmissions and mortality.

2018 Conference Presentation

Data and research FinlandNorway

10 September 2018

Organizing stroke pathways differently – effects on readmissions and mortality.

Terje P Hagen, University of Oslo, Norway

Abstract

Background: Care pathways for stroke patients differ between the capitals of Helsinki, Finland, and Oslo, Norway. While stroke patients living in Helsinki to a higher degree than in Oslo are taken care of in institutions, the Oslo patients to a higher degree receives treatment at home with more intensive follow up by GPs. We question whether the differences in care pathways affect mortality.

Methods: The data included stroke patients hospitalized in the period 2009-2014. We excluded patients being institutionalized before the onset of the stroke to increase comparability. The net sample included approximately 3900 patients from each of the two cities. Logistic regressions were used for analyses. We used age, sex, comorbidities and number of days in institution one year before the onset of the stroke as risk adjusters.

(Preliminary) results: Preliminary results from unadjusted analyses indicate that 30 days mortality are at the same level in the two cities while one year mortality is slightly lower in Helsinki than in Oslo. In preliminary multivariate regressions no significant differences between the two cities are found. Our preliminary conclusion is that a marginal shift from inpatient to home services can be done in Helsinki without reducing quality. Analyses of readmissions will follow.