Department of Health Care Policy, Harvard Medical School, Boston, MA, United States.
University of Vermont Medical School, Burlington, United States.
J Stroke Cerebrovasc Dis. 2023 Apr;32(4):107036. doi: 10.1016/j.jstrokecerebrovasdis.2023.107036. Epub 2023 Feb 6.
Early in the pandemic, there was a substantial increase in telestroke uptake among hospitals. The motivations for using telestroke during the pandemic might have been different than for hospitals that adopted telestroke previously. We compared stroke care at hospitals that adopted telestroke prior to the pandemic to care at hospitals that adopted telestroke during the pandemic.
Stroke episodes and telestroke use were identified in Medicare Fee-for-Service Data. Hospital and episode characteristics were compared between pre-pandemic (Jan. 2019-Mar. 2020) and pandemic (Apr. 2020-Dec. 2020) adopters.
Hospital bed counts, critical access statuses, stroke volumes, clinical operating margins, shares of stroke care via telestroke, and vascular neurology consult rates did not differ significantly between pre-pandemic and pandemic-adopting hospitals. Hospitals that never adopted telestroke during the study period were more likely to be small critical access hospitals with low clinical operating margins.
Compared to hospitals that adopted telestroke before the pandemic, hospitals that adopted telestroke during the pandemic were similar in characteristics and how they used telestroke.
在疫情早期，医院中远程卒中的采用率大幅上升。在疫情期间使用远程卒中的动机可能与之前采用远程卒中的医院不同。我们比较了在疫情之前采用远程卒中的医院和在疫情期间采用远程卒中的医院的卒中护理情况。
在 Medicare 按服务收费数据中确定了卒中发作和远程卒中的使用情况。比较了在大流行前（2019 年 1 月至 2020 年 3 月）和大流行期间（2020 年 4 月至 2020 年 12 月）采用远程卒中的医院的特征。
大流行前和大流行期间采用远程卒中的医院的病床数量、关键接入状态、卒中量、临床运营边际、通过远程卒中提供的卒中护理份额和血管神经病学咨询率没有显著差异。在研究期间从未采用远程卒中的医院更有可能是小型关键接入医院，临床运营边际较低。
与在大流行前采用远程卒中的医院相比，在大流行期间采用远程卒中的医院在特征和远程卒中的使用方式上相似。
