Improving stroke outcomes in NSW: A study of GP perspectives

Abstract

Stroke is the third leading cause of death in western society, imposing a heavy economic burden on communities worldwide. This study investigated NSW general practitioners? (GPs) views on stroke services. A postal survey was conducted of 296 randomly-selected GPs in NSW (60% response fraction). The main outcome measures were: satisfaction with access to specialists and services; GPs? views on the usefulness of quality indicators when referring patients for carotid endarterectomy; GPs? views about services to enhance stroke outcomes. GPs were satisfied with their access to private vascular laboratories (n=199, 67.2%), casualty/ emergency rooms for stroke patients (n=156, 52.7%), and medical beds for acute stroke in their local hospital (n=157, 53.0%). However, rural and remote GPs were significantly less likely than urban GPs to be satisfied with access to neurologists (?2=12.44, P<0.001), vascular surgeons (?2=8.57, P=0.003), public vascular laboratories (?2=9.46, P=0.002), private vascular laboratories (?2=5.19, P=0.02), and multidisciplinary stroke services (?2=6.09, P=0.014). GPs rated discharge planning most highly as a strategy to improve stroke outcomes (n=260, 87.8%). Our results invite particular attention to rural access to diagnostic, preventive and treatment stroke services. Discharge planning to ensure seamless transfer of care from hospital to general practice is also important.