Short CommunicationVariation in patterns of telestroke usage during the COVID-19 pandemic
Section snippets
Sample of stroke and transient ischemic attack episodes
Using 100% Medicare Inpatient and Outpatient Standard Analytic Files, we identified all acute ischemic stroke or transient ischemic attack admissions in the US within the traditional fee-for-service Medicare program from January 2018 to December 2021. Admissions included inpatient or outpatient ED / observation stays in any short-term acute care or critical access hospital with a primary diagnosis for stroke / transient ischemic attack (TIA) (International Classification of Diseases, Ninth
Results
Of the 886 hospitals without telestroke as of January 2019, 108 subsequently introduced telestroke and 778 did not. Of the 108 that introduced telestroke, 42 (39%) introduced the service in the 15-month pre-pandemic period and 66 (61%) in the 9-month pandemic period (Fig. 1). Of the 66 hospitals that introduced it in the pandemic period, 38 (58%) hospitals introduced telestroke in three months (April–June of 2020).
Discussion
Contrary to our expectations, in a comparison of hospitals that adopted telestroke pre-pandemic to early-pandemic adopters, we found few differences in hospital characteristics, how telestroke was used, and whether telestroke was maintained for at least a year. We had hypothesized that hospitals that adopted telestroke during the pandemic would use more local neurologists, but we observe no significant differences in use of local neurologists and that average hospital-neurologist distances were
Grant support
Supported by grant R01-NS111952 from the National Institute of Neurological Disorders and Stroke.
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