Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)

Abstract Background Intracerebral hemorrhage is a devastating disease with no specific treatment modalities. A significant proportion of patients with intracerebral hemorrhage are transferred to large stroke treatment centers, such as Comprehensive Stroke Centers, because of perceived need for highe...

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Main Authors: Farhaan S. Vahidy, Ellie G. Meyer, Arvind B. Bambhroliya, Jennifer R. Meeks, Charles E. Begley, Tzu-Ching Wu, Jon E. Tyson, Charles C. Miller, Ritvij Bowry, Wamda O. Ahmed, Gretchel A. Gealogo, Louise D. McCullough, Steven Warach, Sean I. Savitz
Format: Article
Language:English
Published: BMC 2018-03-01
Series:BMC Neurology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12883-018-1036-1
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author Farhaan S. Vahidy
Ellie G. Meyer
Arvind B. Bambhroliya
Jennifer R. Meeks
Charles E. Begley
Tzu-Ching Wu
Jon E. Tyson
Charles C. Miller
Ritvij Bowry
Wamda O. Ahmed
Gretchel A. Gealogo
Louise D. McCullough
Steven Warach
Sean I. Savitz
spellingShingle Farhaan S. Vahidy
Ellie G. Meyer
Arvind B. Bambhroliya
Jennifer R. Meeks
Charles E. Begley
Tzu-Ching Wu
Jon E. Tyson
Charles C. Miller
Ritvij Bowry
Wamda O. Ahmed
Gretchel A. Gealogo
Louise D. McCullough
Steven Warach
Sean I. Savitz
Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)
BMC Neurology
Stroke
Intracerebral hemorrhage
Patient-centered outcomes
Quality of life
Readmission rate
Mortality
author_facet Farhaan S. Vahidy
Ellie G. Meyer
Arvind B. Bambhroliya
Jennifer R. Meeks
Charles E. Begley
Tzu-Ching Wu
Jon E. Tyson
Charles C. Miller
Ritvij Bowry
Wamda O. Ahmed
Gretchel A. Gealogo
Louise D. McCullough
Steven Warach
Sean I. Savitz
author_sort Farhaan S. Vahidy
title Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)
title_short Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)
title_full Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)
title_fullStr Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)
title_full_unstemmed Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)
title_sort rationale and design of a statewide cohort to examine efficient resource utilization for patients with intracerebral hemorrhage (enrich)
publisher BMC
series BMC Neurology
issn 1471-2377
publishDate 2018-03-01
description Abstract Background Intracerebral hemorrhage is a devastating disease with no specific treatment modalities. A significant proportion of patients with intracerebral hemorrhage are transferred to large stroke treatment centers, such as Comprehensive Stroke Centers, because of perceived need for higher level of care. However, evidence of improvement in patient-centered outcomes for these patients treated at larger stroke treatment centers as compared to community hospitals is lacking. Methods / design “Efficient Resource Utilization for Patients with Intracerebral Hemorrhage (EnRICH)” is a prospective, multisite, state-wide, cohort study designed to assess the impact of level of care on long-term patient-centered outcomes for patients with primary / non-traumatic intracerebral hemorrhage. The study is funded by the Texas state legislature via the Lone Star Stroke Research Consortium. It is being implemented via major hub hospitals in large metropolitan cities across the state of Texas. Each hub has an extensive network of “spoke” hospitals, which are connected to the hub via traditional clinical and administrative arrangements, or by telemedicine technologies. This infrastructure provides a unique opportunity to track outcomes for intracerebral hemorrhage patients managed across a health system at various levels of care. Eligible patients are enrolled during hospitalization and are followed for functional, quality of life, cognitive, resource utilization, and dependency outcomes at 30 and 90 days post discharge. As a secondary aim, an economic analysis of the incremental cost-effectiveness of treating intracerebral hemorrhage patients at higher levels of care will be conducted. Discussion Findings from EnRICH will provide much needed evidence of the effectiveness and efficiency of regionalized care for intracerebral hemorrhage patients. Such evidence is required to inform policy and streamline clinical decision-making.
topic Stroke
Intracerebral hemorrhage
Patient-centered outcomes
Quality of life
Readmission rate
Mortality
url http://link.springer.com/article/10.1186/s12883-018-1036-1
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spelling doaj-f25b85eb557b40d6bea7738732665f102020-11-25T01:02:57ZengBMCBMC Neurology1471-23772018-03-011811810.1186/s12883-018-1036-1Rationale and Design of a Statewide Cohort to examine efficient resource utilization for patients with Intracerebral hemorrhage (EnRICH)Farhaan S. Vahidy0Ellie G. Meyer1Arvind B. Bambhroliya2Jennifer R. Meeks3Charles E. Begley4Tzu-Ching Wu5Jon E. Tyson6Charles C. Miller7Ritvij Bowry8Wamda O. Ahmed9Gretchel A. Gealogo10Louise D. McCullough11Steven Warach12Sean I. Savitz13Department of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthDepartment of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthDepartment of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthDepartment of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthDepartment of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at HoustonDepartment of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthCenter for Clinical Research and Evidence Based Medicine at McGovern Medical School, University of Texas Health Science Center at HoustonCenter for Clinical Research and Evidence Based Medicine at McGovern Medical School, University of Texas Health Science Center at HoustonDepartment of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at HoustonDepartment of Neurosurgery, McGovern Medical School, University of Texas Health Science Center at HoustonDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology and the Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, University of Texas - HealthAbstract Background Intracerebral hemorrhage is a devastating disease with no specific treatment modalities. A significant proportion of patients with intracerebral hemorrhage are transferred to large stroke treatment centers, such as Comprehensive Stroke Centers, because of perceived need for higher level of care. However, evidence of improvement in patient-centered outcomes for these patients treated at larger stroke treatment centers as compared to community hospitals is lacking. Methods / design “Efficient Resource Utilization for Patients with Intracerebral Hemorrhage (EnRICH)” is a prospective, multisite, state-wide, cohort study designed to assess the impact of level of care on long-term patient-centered outcomes for patients with primary / non-traumatic intracerebral hemorrhage. The study is funded by the Texas state legislature via the Lone Star Stroke Research Consortium. It is being implemented via major hub hospitals in large metropolitan cities across the state of Texas. Each hub has an extensive network of “spoke” hospitals, which are connected to the hub via traditional clinical and administrative arrangements, or by telemedicine technologies. This infrastructure provides a unique opportunity to track outcomes for intracerebral hemorrhage patients managed across a health system at various levels of care. Eligible patients are enrolled during hospitalization and are followed for functional, quality of life, cognitive, resource utilization, and dependency outcomes at 30 and 90 days post discharge. As a secondary aim, an economic analysis of the incremental cost-effectiveness of treating intracerebral hemorrhage patients at higher levels of care will be conducted. Discussion Findings from EnRICH will provide much needed evidence of the effectiveness and efficiency of regionalized care for intracerebral hemorrhage patients. Such evidence is required to inform policy and streamline clinical decision-making.http://link.springer.com/article/10.1186/s12883-018-1036-1StrokeIntracerebral hemorrhagePatient-centered outcomesQuality of lifeReadmission rateMortality