Stroke care study published
Posted on 25/02/2011
A patient receiving care
The quality of stroke care in the UK is improving, but significant inequalities still exist, according to a study by a team of researchers and clinicians at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, as part of King’s Health Partners.
The study was published in the British Medical Journal this week. Previous reports have suggested that the quality of UK stroke care is improving, but there is limited information on trends of care from population-based studies. The team therefore assessed the provision of acute stroke care for 3,800 patients registered on the south London stroke register between 1995 and 2009.
They measured the provision of effective acute stroke care, in line with current guidelines, against demographic factors such as age, sex, ethnic origin and socioeconomic status.
The proportion of patients receiving effective acute stroke care interventions increased substantially between 1995 and 2009.
However, between 2007 and 2009, five percent of patients were still not admitted to hospital after an acute stroke, particularly those with milder strokes, and 21percent of patients were not admitted to a stroke unit.
They also found a disproportionate access to effective care. For example, compared with white patients, black patients had significantly increased odds of being admitted to a stroke unit and receiving occupational therapy or physiotherapy, independent of age or stroke severity.
The odds of brain imaging were lowest in older patients (aged 75 or more years) and those of lower socioeconomic status, whereas older patients were more likely to receive occupational therapy or physiotherapy.
Professor Charles Wolfe, Head of the Department of Primary Care and Public Health Sciences at King’s, said: ‘Our findings suggest a disproportionate access to interventions for people who have suffered a stroke, despite a Government goal of universal access to healthcare.
‘We found that black patients and those with motor or swallowing deficits are more likely to be admitted to a stroke unit, yet the justification for the decision-making is not evidence-based.
‘It is also extremely important to ensure that elderly patients are not excluded from these services deliberately, as lower rates of brain imaging have implications in delivering effective acute treatment as well as the initiation of secondary prevention measures that could possibly result in poorer outcomes.’
Notes to editors
King's College London
King's College London is one of the top 25 universities in the world (2010 QS international world rankings), The Sunday Times 'University of the Year 2010/11' and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,000 students (of whom more than 8,600 are graduate students) from nearly 140 countries, and some 5,500 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit:
www.kingshealthpartners.org.
For further information please contact Emma Reynolds, Press Officer at King’s College London, on 0207 848 4334 or email emma.reynolds@kcl.ac.uk