Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Casper ML[original query] |
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Mapping primary and comprehensive stroke centers by certification organization
Schieb LJ , Casper ML , George MG . Circ Cardiovasc Qual Outcomes 2015 8 S193-4 In 2000, members of the Brain Attack Coalition published recommendations for the establishment of primary stroke centers (PSCs),1 and in 2005 they published recommendations for the establishment of comprehensive stroke centers (CSCs).2 To improve patient care and outcomes for stroke, the recommendations suggested that stroke centers should include acute stroke teams, written care protocols, emergency medical services integrated with the stroke center, rapid testing procedures, and continuous improvement processes. Since then, several certification programs have been developed to identify hospitals that have established a stroke center that meets specific criteria for the treatment of stroke. | The Joint Commission, DNV GL, and Healthcare Facilities Accreditation Program offer certification programs for PSCs and CSCs. PSC certification was designed to meet the Brain Attack Coalition’s recommendations for improved stroke care through access to dedicated, specialized personnel and procedures. CSCs must meet all of the requirements for certification as a PSC, plus additional requirements meant to help manage complex stroke cases. These include the requirements to meet specified volumes of patients and procedures, be capable of providing advanced imaging on-site at all times, provide after hospital care coordination for patients, have dedicated neurological intensive care unit beds for complex stroke cases, participate in stroke research, and collect standard performance measures.3 |
Decomposing black-white disparities in heart disease mortality in the United States, 1973-2010: an age-period-cohort analysis
Kramer MR , Valderrama AL , Casper ML . Am J Epidemiol 2015 182 (4) 302-12 Against the backdrop of late 20th century declines in heart disease mortality in the United States, race-specific rates diverged because of slower declines among blacks compared with whites. To characterize the temporal dynamics of emerging black-white racial disparities in heart disease mortality, we decomposed race-sex-specific trends in an age-period-cohort (APC) analysis of US mortality data for all diseases of the heart among adults aged ≥35 years from 1973 to 2010. The black-white gap was largest among adults aged 35-59 years (rate ratios ranged from 1.2 to 2.7 for men and from 2.3 to 4.0 for women) and widened with successive birth cohorts, particularly for men. APC model estimates suggested strong independent trends across generations ("cohort effects") but only modest period changes. Among men, cohort-specific black-white racial differences emerged in the 1920-1960 birth cohorts. The apparent strength of the cohort trends raises questions about life-course inequalities in the social and health environments experienced by blacks and whites which could have affected their biomedical and behavioral risk factors for heart disease. The APC results suggest that the genesis of racial disparities is neither static nor restricted to a single time scale such as age or period, and they support the importance of equity in life-course exposures for reducing racial disparities in heart disease. |
Transfer of residents to hospital prior to cardiac death: the influence of nursing home quality and ownership type
Anic GM , Pathak EB , Tanner JP , Casper ML , Branch LG . Open Heart 2014 1 (1) e000041 OBJECTIVES: We hypothesised that among nursing home decedents, nursing home for-profit status and poor quality-of-care ratings, as well as patient characteristics, would lower the likelihood of transfer to hospital prior to heart disease death. METHODS: Using death certificates from a large metropolitan area (Tampa Florida Metropolitan Statistical Area) for 1998-2002, we geocoded residential street addresses of heart disease decedents to identify 2172 persons who resided in nursing homes (n=131) at the time of death. We analysed decedent place of death as an indicator of transfer prior to death. Multilevel logistic regression modelling was used for analysis. Cause of death and decedent characteristics were obtained from death certificates. Nursing home characteristics, including state inspector ratings for multiple time points, were obtained from Florida's Agency for Healthcare Administration. RESULTS: Nursing home for-profit status, level of nursing care and quality-of-care ratings were not associated with the likelihood of transfer to hospital prior to heart disease death. Nursing homes >5 miles from a hospital were more likely to transfer decedents, compared with facilities located close to a hospital. Significant predictors of no transfer for nursing home residents were being white, female, older, less educated and widowed/unmarried. CONCLUSIONS: In this study population, contrary to our hypotheses, sociodemographic characteristics of nursing home decedents were more important predictors of no transfer prior to cardiac death than quality rankings or for-profit status of nursing homes. |
Metropolitan racial residential segregation and cardiovascular mortality: exploring pathways
Greer S , Kramer MR , Cook-Smith JN , Casper ML . J Urban Health 2013 91 (3) 499-509 Racial residential segregation has been associated with an increased risk for heart disease and stroke deaths. However, there has been little research into the role that candidate mediating pathways may play in the relationship between segregation and heart disease or stroke deaths. In this study, we examined the relationship between metropolitan statistical area (MSA)-level segregation and heart disease and stroke mortality rates, by age and race, and also estimated the effects of various educational, economic, social, and health-care indicators (which we refer to as pathways) on this relationship. We used Poisson mixed models to assess the relationship between the isolation index in 265 U.S. MSAs and county-level (heart disease, stroke) mortality rates. All models were stratified by race (non-Hispanic black, non-Hispanic white), age group (35-64 years, ≥65 years), and cause of death (heart disease, stroke). We included each potential pathway in the model separately to evaluate its effect on the segregation-mortality association. Among blacks, segregation was positively associated with heart disease mortality rates in both age groups but only with stroke mortality rates in the older age group. Among whites, segregation was marginally associated with heart disease mortality rates in the younger age group and was positively associated with heart disease mortality rates in the older age group. Three of the potential pathways we explored attenuated relationships between segregation and mortality rates among both blacks and whites: percentage of female-headed households, percentage of residents living in poverty, and median household income. Because the percentage of female-headed households can be seen as a proxy for the extent of social disorganization, our finding that it has the greatest attenuating effect on the relationship between racial segregation and heart disease and stroke mortality rates suggests that social disorganization may play a strong role in the elevated rates of heart disease and stroke found in racially segregated metropolitan areas. |
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