Abstract T P284: Trends in Ontario’s Stroke Report Cards

Background: In 2011, the Ontario Stroke Evaluation and Quality Committee created Ontario’s Stroke Report Card, consisting of twenty indicators with potential to influence system performance and flow of stroke patients across the care continuum. The provincial report card and 14 regional report cards serve as a valuable stakeholder tool that allows for consistent planning across the province. Purpose: To evaluate stroke system performance at the provincial and regional level by comparing recent performance to previous three-year performance. Methods: Indicator performance was analyzed at the LHIN and provincial levels for 19 of 20 indicators with available data. Statistical significance was determined by comparing the most recent year’s performance to the combined average of the previous three years performance. A chi-square test, Wilcoxon rank-sum test, and Poisson and logistic regressions were used where appropriate. Eight indicators used FY2004/05, FY2008/09, FY2010/11 and FY2012/13 Ontario Stroke Audit of acute care facilities data and eleven used FY2009/10-FY2012/13 Canadian Institute for Health Information administrative databases and one used the Ontario Home Care Database, FY2008/09-FY2012/13. Results: In Ontario, 15 of 19 indicators showed statistically significant improvement from the previous 3 years. Only one indicator showed a statistically significant decline and the remaining three indicators improved but were non-significant (p > 0.05). Among the regional report cards, the number of indicators with statistical significant improvement ranged from 3-10 and 0-2 with statistical significant decline. Conclusion: The stroke report cards reflect steady improvement in stroke prevention, acute management and rehabilitation in Ontario. These improvements are in the absence of financial incentives such as pay for performance suggesting there is great capacity for the health system to improve using targeted performance reports.