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Frequently Asked Questions
What is Quality Improvement?
How many hospitals participate in
SCORE?
What is the burden of stroke in
Massachusetts?
What are the risk factors for stroke
What are the signs and symptoms of stroke?
What
is Quality Improvement?
Quality improvement includes efforts made my hospitals
to improve the care and treatment of patients based on the evidence for
certain processes and procedures to reduce errors and improve outcomes.
SCORE focuses specifically on evidence-based performance measures
related to acute stroke care including acute treatment in the Emergency
Department and in-patient setting as well as secondary prevention
measures at discharge. Adherence to these measures has been shown to
improve patient outcome including, reducing the risk of death,
disability and recurrent stroke.
How
many hospitals in MA participate in SCORE?
Currently, 57 hospitals are participating in SCORE.
Fifty-five of them are MA acute care hospitals with Primary Stroke
Service designation.
What
is the burden of stroke in Massachusetts?
The rate of stroke in MA differs by age group, gender,
race/ethnicity, and socioeconomic status. Overall in 2005, 3%
of MA adults age 35 or older reported having had a stroke. People
ages 75 and older reported 11 times the level of stroke as those ages
35-44. Men are more likely to report stroke (4% vs. 2%) than
women. Additionally, those at the lowest end of the
income scale are more likely than those at the highest to report having
had a stroke.
Stroke is the third overall leading cause of death in MA. The Healthy People 2010 (HP 2010) goal for stroke deaths is 48 deaths per 100,000 people. In 2004, 43 per 100,000 MA residents died from stroke. While this rate meets the HP 2010 target, stroke deaths in MA have not significantly decreased since 1994.
The mortality rate for stroke rises with increasing age. The rate of death for stroke more than triples with each added decade of life from age 45 on. Since the MA population ages 65 and older is projected to increase by 70% from 2000 to 2030, stroke will become an increasing concern. Moreover, race/ethnicity plays a role in stroke deaths. In 2004, Black, non-Hispanics had the highest stroke mortality rate, followed by White, non-Hispanics, Hispanics, and Asian/Pacific Islanders (56, 42, 36, and 34 per 100,000, respectively).
Substantial disparities exist in stroke death rates among MA residents with different levels of education. Less schooling is associated with higher rates of death from coronary heart disease or stroke. In 2004, MA adults ages 25-64 with a high school education or less were nearly four times as likely to die from stroke (13 vs. 4 per 100,000) as those who had completed at least one year of higher education.
Some MA communities carry a more disproportionate burden of stroke than others. These differences in prevalence and mortality may reflect racial/ethnic, socioeconomic, and age differences among the communities. As a result, six cities have been identified as geographic priority areas for focusing statewide efforts towards reducing stroke and health disparities in MA: Fall River, Lawrence, Lowell, New Bedford, Springfield, and Worcester.
he 2004 stroke death rates in Fall River and Lowell were higher than the HP 2010 goal of 48 deaths per 100,000. Moreover, stroke death rates for New Bedford and Worcester exceeded the overall state rate.
What
are the risk factors for stroke?
Eighty percent of strokes are preventable! Several of
the risk factors for stroke are modifiable and by controlling them you
can reduce your likelihood of developing disease. For
example, blood pressure, cholesterol, diabetes, tobacco use,
overweight, poor nutrition, and inactivity patterns. Other
risk factors are non-modifiable and cannot be changed including: family
history, gender, age, and race.
Information on how to reduce your risk of stroke and other diseases by controlling modifiable risk factors is provided on the following websites:
American Stroke Association
National Stroke Association
CDC
What
are the signs and symptoms of a stroke:
The most common signs and symptoms of stroke involve a
persons face, arm, and speech. People suffering from a stroke
may experience a droop on one side of their face, weakness or tingling
in one arm, and or inability to speak or form coherent
sentences. The FAST acronym incorporates these concepts and T
for time to remind people that a stroke is an emergency and it is
important to react quickly. The Massachusetts
Department of Public Health has developed an educational
campaign on recognizing the signs and symptoms of stroke using the FAST
acronym. Key concepts include asking a person to smile, raise
both arms, and repeat a sentence. If they are unable to
perform any of these 3 tasks 9-1-1 should be called and the person
should be taken to the hospital. The FAST materials were developed as
part of the objective to address all aspects of the stroke systems of
care model including primary prevention, recognition of signs and
symptoms, emergency response, acute hospital care and discharge,
rehabilitation, post-hospital and secondary prevention. FAST
materials in English, Spanish and Portuguese are available on the Massachusetts
Health Promotion Clearinghouse Catalog.
Last updated March 29, 2010.
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