Evidence defining high-quality stroke care has improved dramatically in the past 20 years; however, the gap between evidence and practice persists in stroke prevention, treatment, and rehabilitation.1 Although clinical trials have been instrumental in advancing the science supporting evidence- based guidelines, research is needed to identify gaps and factors contributing to gaps in care and outcomes and to develop strategies that promote uptake of evidence-based treatment and services for stroke patients. This article discusses health services research (HSR) as a multidisciplinary field encompassing outcomes research, implementation science, and financial evaluations that can address critical evidence, practice and policy gaps in stroke care.
|State||Published - May 1 2019|
Bibliographical noteFunding Information:
Opportunities to compare long term costs of care and effectiveness of preventive and therapeutic therapies are abundant. Comparative clinical and cost-effectiveness research of different therapeutic modalities helps payers, providers, and patients in decision-making. Cost-effectiveness models simulate real-world population outcomes and estimate the incremental cost relative to the net gain in quality-adjusted life years. For example, data from the Interventional Management of Stroke III Trial, funded by the United States National Institutes of Health, were used to evaluate variations in outcomes and cost observed over 12 months for subjects receiving endovascular therapy compared with intravenous tissue-type plasminogen activator alone. Financial evaluations can demonstrate the economic incentive for investment in improvements in the care process for acute and postacute stroke.
National Institutes of Health (eg, T32 National Research Service Award)
J. Prvu Bettger receives Research funding from the Patient-Centered Outcomes Research Institute, National Institutes of Health, and the Medical Research Council. The other authors report no conflicts.
© 2019 American Heart Association, Inc.
- health behavior
- health services research
- population health
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialized Nursing