Ischemic Stroke Transfer Patterns in the Northeast United States

Area of Science:

• Neurology
• Health Services Research
• Medical Informatics

Background:

• Understanding hospital networks for ischemic stroke (IS) patient transfers is limited.
• This study examines characteristics of transferred vs. non-transferred IS patients and hospital connections in the Northeastern US.

Purpose of the Study:

• To describe differences in transferred vs. non-transferred IS patients.
• To characterize transferring and receiving hospitals in the Northeastern US.
• To analyze changes in IS patient transfer networks over time.

Main Methods:

• Utilized Medicare claims data (2007-2011), linked with Get with the Guidelines-Stroke registry.
• Defined receiving hospitals by IS volume and transfer percentage; transferring hospitals by transfer percentage.
• Network visualization performed using ArcGIS 10.3.1.

Main Results:

• 3.9% of 177,270 IS admissions were transferred; transferred patients were younger with more severe strokes.
• Patient transfers, transferring hospitals, and receiving hospitals significantly increased from 2007 to 2011.
• Most transferring hospitals connected to only one receiving hospital.

Conclusions:

• Hospital connectivity for IS patient care increased in the Northeastern US between 2007-2011.
• Despite increased connectivity, most hospitals remained isolated.
• Further network analysis is crucial for improving regional stroke systems of care.