Only a few states have organized acute stroke registries to identify, monitor and improve quality of care, but no state program has specifically been organized to make stroke disparities a primary focus. Publications from the AHA Get With the Guidelines (GWTG) Stroke have demonstrated that adherence to evidencebased guidelines is an effective way to reduce race-ethnic disparities in acute stroke care. Florida and Puerto Rico have one of the largest populations of Caribbean Hispanics in the US, as well as one of the largest saturation of hospitals collecting quality performance data as part ofthe GWTG-Stroke program. At present, nearly 140 hospitals are collecting GWTG-Stroke data in Florida and Puerto Rico. In 2011 within this region, GWTG-Stroke data consisted of 31,922 records of stroke hospitalizations with 16% among African Americans and 14% among Hispanics. The proportion of Hispanic stroke cases is twice that ofthe nationwide sample. We propose to initiate the Florida Puerto Rico Stroke Registry starting with the collation of GWTG-Stroke hospitals into a voluntary registry to accumulate data at the University of Miami into a super user group. Our goal is to identify disparities in acute stroke care by race, ethnicity, and region and educate stakeholders in approaches to improve stroke quality regarding stroke disparities. We will initiate additional data collection regarding identification of Hispanic subgroups, increase utilization ofthe 30day GWTG-Stroke data collection form, analyze a matched CMS Medicare sample, and enhance the focus ofthe registry to address outcomes and secondary stroke prevention targets. We have instituted a Florida Puerto Rico Stroke Advisory Committee to oversee the data analyses and advise stakeholders on results as well as initiate programs to address disparities. Enhanced communication across the region regarding stroke care with a focus on disparities will be implemented through webinars, teleconferences, websites, listservs, and annual meetings. This voluntary stroke registry could be one ofthe largest in the country based on the number of GWTG-Stroke hospitals already collecting data and will make an immediate impact on reducing stroke disparities.
Disparities in acute stroke care and secondary prevention exist for African Americans, but are less welldocumented in the rapidly growing Hispanic population. We will utilize the Get With the Gudielines Stroke data collection effort across a region to create a voluntarty stroke registry. The Florida Puerto Rico Stroke Registry will be one ofthe largest stroke registries to monitor, evaluate and reduce stroke disparities.
|Rundek, Tatjana; Brown, Devin L (2014) Socioeconomic status and subclinical atherosclerosis: are we closing disparity gaps? Stroke 45:948-9|