QUALITY OF HOSPITAL-CARE FOR STROKE PATIENTS IN THE NETHERLANDS

To assess the quality of some aspects of medical hospital care an expl icit review instrument (a 'criteria map') was developed on the basis o f available evidence and consensus statements. The criteria are presen ted as 'optimal care trajectories', which depend on the patient's clin ical profile. The criteria map was applied in a study of 738 stroke pa tients over 45 years of age. We observed for 44% of the 738 studied pa tients one or more deviations from the optimal care trajectory with re spect to at least one of five important aspects of medical care (CT sc an, reversal of anticoagulation, treatment of hypertension, antiplatel et therapy, and evaluation of carotid arteries). The frequency of devi ations from optimal care increased with patients' age and level of dis ability. We conclude that the criteria map is a reliable tool for case -by-case review of the quality of care.