RT Journal Article
SR Electronic
T1 Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP 86
OP 88
DO 10.1136/svn-2022-001662
VO 8
IS 1
A1 Carter H Nakamoto
A1 Andrew D Wilcock
A1 Lee H Schwamm
A1 Jennifer J Majersik
A1 Kori S Zachrison
A1 Ateev Mehrotra
YR 2023
UL http://svn.bmj.com/content/8/1/86.abstract
AB Introduction Patients with acute ischaemic strokes (AIS), on average, fare better with timely neurologist consultation, and a growing proportion of them receive one. However, little is known about trends in the characteristics of neurologists who treat AIS.Methods We identified AIS and transient ischaemic attack (TIA) episodes with neurologist consults in fee-for-service Medicare from January 2008 to September 2021. For each episode, we determined whether the neurologist was a vascular neurologist, was a high-volume provider, whether the patient was transferred between hospitals and the distance between the patient’s home and physician’s practice.Results From 2008 to 2021, the share of AIS/TIA episodes (n=5 073 294) with neurologist consults increased (52.9% to 61.7%). Among episodes with consults, the fraction conducted by a vascular neurologist (5.2% to 13.7%) or by a high-volume neurologist (13.2% to 14.9%) also increased. The fraction with the patient’s home and neurologist greater than 100 miles apart (4.8% to 9.6%) or in different states (5.1% to 8.1%) increased, as did the fraction with transfers (4.2% to 8.5%).Discussion Over the study period, the proportion of AIS/TIA episodes with consultations from neurologists with either vascular neurology certifications or high volumes increased substantially.