title: Application of the World Stroke Organization health system indicators and performance in Australia, Singapore, and the USA.
abstract: Aim To examine how Australia, Singapore and the United States of America (USA) match to the World Stroke Organization Global Stroke Services health system monitoring indicators (HSI). Design Descriptive comparative study Participants The health systems of Australia, Singapore, the USA. Outcome measures Published data available from each country were mapped to the 10 health system monitoring indicators proposed by the World Stroke Organization. Results Most health system monitoring indicators were at least partially met in each country. Thrombolytic agents were available for use in acute stroke. Stroke guidelines and stroke registry data were available in all three countries. Stroke incidence, prevalence, and mortality rates were available but at non-uniform times post-stroke. The International Classification of Disease 9 or 10 coding systems are used in all three countries. Standardized clinical audits are routine in Australia and the USA, but not in Singapore. The use of the modified Rankin Scale is collected sub-acutely but not at one year post-stroke in all three countries. Conclusions The three developed countries are performing well against the World Stroke Organization health system monitoring indicators for acute and sub-acute stroke care. However, improvements in stroke risk assessment and at one-year post-stroke outcome measurement are needed.
authors.affiliation: 1 Occupational Therapy, Department of Community and Clinical Allied Health, School of Allied Health, La Trobe University, Victoria, Australia.|2 Stroke Division, The Florey Institute of Neuroscience and Mental Health Heidelberg, Victoria, Australia.
authors.forename: Tamara
authors.initials: T
authors.lastname: Tse
authors.affiliation: 1 Occupational Therapy, Department of Community and Clinical Allied Health, School of Allied Health, La Trobe University, Victoria, Australia.|2 Stroke Division, The Florey Institute of Neuroscience and Mental Health Heidelberg, Victoria, Australia.
authors.forename: Leeanne
authors.initials: L
authors.lastname: Carey
authors.affiliation: 1 Occupational Therapy, Department of Community and Clinical Allied Health, School of Allied Health, La Trobe University, Victoria, Australia.|3 Department of Medicine, School of Clinical Sciences, Monash University, Victoria, Australia.
authors.forename: Dominique
authors.initials: D
authors.lastname: Cadilhac
authors.affiliation: 4 Saw Swee Hock School of Public Health, National University of Singapore, National University Health System.
authors.forename: Gerald Choon-Huat
authors.initials: GC
authors.lastname: Koh
authors.affiliation: 5 Washington University in St Louis, St Louis, MO, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Baum
mesh_terms: D001315:Australia; D006801:Humans; D019984:Quality Indicators, Health Care; D012846:Singapore; D012955:Societies, Medical; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D014481:United States
keywords: Australia; Health System Indicators; Singapore; Stroke; United States of America; World Stroke Organization