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Frequently Asked Questions
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.
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.
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:
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.