Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021
Introduction Patients with acute ischaemic strokes (AIS), on average, fare better with timely neurologist consultation, and a growing proportion of them receive one. However, little is known about trends in the characteristics of neurologists who treat AIS.Methods We identified AIS and transient isc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
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| Series: | Stroke and Vascular Neurology |
| Online Access: | https://svn.bmj.com/content/early/2022/07/28/svn-2022-001662.full |
| _version_ | 1818017450065657856 |
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| author | Lee H Schwamm Kori S Zachrison Jennifer J Majersik Ateev Mehrotra Carter H Nakamoto Andrew D Wilcock |
| author_facet | Lee H Schwamm Kori S Zachrison Jennifer J Majersik Ateev Mehrotra Carter H Nakamoto Andrew D Wilcock |
| author_sort | Lee H Schwamm |
| collection | DOAJ |
| description | Introduction Patients with acute ischaemic strokes (AIS), on average, fare better with timely neurologist consultation, and a growing proportion of them receive one. However, little is known about trends in the characteristics of neurologists who treat AIS.Methods We identified AIS and transient ischaemic attack (TIA) episodes with neurologist consults in fee-for-service Medicare from January 2008 to September 2021. For each episode, we determined whether the neurologist was a vascular neurologist, was a high-volume provider, whether the patient was transferred between hospitals and the distance between the patient’s home and physician’s practice.Results From 2008 to 2021, the share of AIS/TIA episodes (n=5 073 294) with neurologist consults increased (52.9% to 61.7%). Among episodes with consults, the fraction conducted by a vascular neurologist (5.2% to 13.7%) or by a high-volume neurologist (13.2% to 14.9%) also increased. The fraction with the patient’s home and neurologist greater than 100 miles apart (4.8% to 9.6%) or in different states (5.1% to 8.1%) increased, as did the fraction with transfers (4.2% to 8.5%).Discussion Over the study period, the proportion of AIS/TIA episodes with consultations from neurologists with either vascular neurology certifications or high volumes increased substantially. |
| first_indexed | 2024-04-14T07:27:19Z |
| format | Article |
| id | doaj.art-4ce89ff49c564c88bc2e7fcf3d3a5304 |
| institution | Directory Open Access Journal |
| issn | 2059-8696 |
| language | English |
| last_indexed | 2024-04-14T07:27:19Z |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Stroke and Vascular Neurology |
| spelling | doaj.art-4ce89ff49c564c88bc2e7fcf3d3a53042022-12-22T02:05:59ZengBMJ Publishing GroupStroke and Vascular Neurology2059-869610.1136/svn-2022-001662Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021Lee H Schwamm0Kori S Zachrison1Jennifer J Majersik2Ateev Mehrotra3Carter H Nakamoto4Andrew D Wilcock52 Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USADepartment of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA10Department of Neurology, University of Utah, Salt Lake City, Utah, USAassociate professorDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USADepartment of Family Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont, USAIntroduction Patients with acute ischaemic strokes (AIS), on average, fare better with timely neurologist consultation, and a growing proportion of them receive one. However, little is known about trends in the characteristics of neurologists who treat AIS.Methods We identified AIS and transient ischaemic attack (TIA) episodes with neurologist consults in fee-for-service Medicare from January 2008 to September 2021. For each episode, we determined whether the neurologist was a vascular neurologist, was a high-volume provider, whether the patient was transferred between hospitals and the distance between the patient’s home and physician’s practice.Results From 2008 to 2021, the share of AIS/TIA episodes (n=5 073 294) with neurologist consults increased (52.9% to 61.7%). Among episodes with consults, the fraction conducted by a vascular neurologist (5.2% to 13.7%) or by a high-volume neurologist (13.2% to 14.9%) also increased. The fraction with the patient’s home and neurologist greater than 100 miles apart (4.8% to 9.6%) or in different states (5.1% to 8.1%) increased, as did the fraction with transfers (4.2% to 8.5%).Discussion Over the study period, the proportion of AIS/TIA episodes with consultations from neurologists with either vascular neurology certifications or high volumes increased substantially.https://svn.bmj.com/content/early/2022/07/28/svn-2022-001662.full |
| spellingShingle | Lee H Schwamm Kori S Zachrison Jennifer J Majersik Ateev Mehrotra Carter H Nakamoto Andrew D Wilcock Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021 Stroke and Vascular Neurology |
| title | Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021 |
| title_full | Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021 |
| title_fullStr | Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021 |
| title_full_unstemmed | Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021 |
| title_short | Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021 |
| title_sort | trends in characteristics of neurologists who provide stroke consultations in the usa 2008 2021 |
| url | https://svn.bmj.com/content/early/2022/07/28/svn-2022-001662.full |
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