BACKGROUND/RATIONALE:
Within the Veterans Health Administration (VHA), approximately 6000 veterans are hospitalized with acute ischemic stroke annually. Tissue plasminogen activator (tPA) is the only medication that is Food and Drug Administration (FDA) approved for the treatment of acute ischemic stroke. Guidelines support the use of tPA in eligible patients with acute ischemic stroke for the reduction of stroke symptom severity.

OBJECTIVE(S):
To examine the use and misuse of thrombolytic therapy in a national sample of veterans who were admitted to a VHA Medical Center (VAMC) with acute ischemic stroke.

METHODS:
Medical record reviews were conducted on 5000 acute stroke patients who were admitted to a VAMC in 2007. Patients were defined as eligible to receive tPA if they arrived at the hospital within 3 hours of stroke symptom onset and had no contraindications to tPA. We compared eligible patients who received tPA to those who did not and examined the distribution of eligible patients across the 130 VAMCs included in this study.


FINDINGS/RESULTS:
Not yet available.

IMPACT:
We found that relatively few eligible veterans receive thrombolysis across the VHA system and that strategies to improve thrombolysis delivery will have to account for the low annual volume of eligible stroke patients cared for at individual VAMCs. This work has informed our on-going work to assist VA policymakers to better plan VA stroke care. Our stroke make-buy model, allows the leadership of each VAMC to individually assess the costs of internal versus outsourced stroke care.

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External Links for this Project

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PUBLICATIONS:

None at this time.

DRA: Aging, Older Veterans' Health and Care, Health Systems Science, Brain and Spinal Cord Injuries and Disorders, Cardiovascular Disease
DRE: Treatment - Observational, Prevention
Keywords: none
MeSH Terms: none