Stroke patients admitted to rural hospitals over the weekend may be at higher risk of death, according to new research from University of Georgia researchers, in Journal of Stroke & Cerebrovascular Diseases.
“The weekend effect is the phenomenon where the risk of bad or adverse outcomes, such as mortality in our study, increases for those who are admitted to the hospital over the weekend as opposed to a weekday.”
— lead author Birook Mekonnen, who conducted the study as a graduate student at UGA’s College of Public Health
There are many ideas about why this effect exists, he said, and some smaller studies have pointed to reduced hospital staffing over weekends and limitations in overall hospital resources, a media release from University of Georgia notes.
Magnifying Glass on the Numbers
To better understand the dynamics of the weekend effect, Mekonnen and his co-authors wanted to investigate patient outcomes for different types of strokes admitted to hospitals over the weekend nationwide.
Using a 2016 sample of inpatient hospital data, the team looked at the hospital deaths connected to ischemic and hemorrhagic strokes in rural and urban facilities across the U.S.
They found evidence to support the weekend effect in both urban and rural hospitals, but the outcomes were especially bad for rural patients who suffered from hemorrhagic strokes.
The day of the week may just be one factor in a larger trend of unfavorable stroke outcomes for rural patients, shares co-author Donglan “Stacy” Zhang, an assistant professor of health policy and management in public health.
Hospitals in rural areas tend to operate with fewer resources, including fewer if any stroke specialists or the equipment to handle particularly severe cases. They also serve a wider geographic area, she said. In most rural communities, it’s not uncommon to drive over an hour to reach the nearest hospital.
That’s why the authors wanted to look at both location and type of stroke, the release continues.
“Ischemic strokes are more common, but hemorrhagic strokes are more severe. You tend to see higher mortality rates with hemorrhagic strokes. Timely care is critical.”
— Birook Mekonnen
The good news is that more rural facilities are joining telestroke care networks, where providers in rural hospitals can connect with stroke specialists and collaborate on treatment when a patient arrives with signs of stroke.
Protect Against ‘Weekend Effect’?
So, what can be done to protect patients, especially rural ones, from the weekend effect? The authors recommend further investment in telemedicine.
And one silver lining of the current coronavirus pandemic is that it has triggered a wider adoption of telemedicine among health insurers, providers and patients.
While a patient still needs hands-on treatment for stroke, Zhang says, medical providers may be able to diagnose the type of stroke using telemedicine, which speeds up treatment once the patient arrives at the hospital. She urges more policies favoring telemedicine, including payment reimbursement.
Mekonnen encourages individuals who are at risk for stroke or other major health events to look into the telemedicine options available to them. “This may be the new norm,” he concludes.
[Source(s): University of Georgia, EurekAlert]
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