title: Reasons why few patients with acute stroke receive tissue plasminogen activator.
abstract: Despite the US Food and Drug Administration's approval in 1996, tissue plasminogen activator (tPA) therapy for acute ischemic stroke remains substantially underused. We reviewed 3 potential reasons for low rates of tPA use: poor patient education, physicians' perceived risk of legal liability from negative patient outcomes, and insufficient reimbursement. The recent addition of diagnosis-related grouping code 559 will provide higher payment for stroke patients treated with tPA, creating a natural experiment to examine our third reason.
authors: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA.
authors: Kara Z
authors: KZ
authors: Bambauer
authors: S Claiborne
authors: SC
authors: Johnston
authors: Derek E
authors: DE
authors: Bambauer
authors: Justin A
authors: JA
authors: Zivin