A+ Grade Work
The Queen's Health Policy Research Unit (QHPRU) estimated the need for stroke services in Brooklyn, New York using measures of prevalence and incidence of:
(1) MODIFIABLE AND NONMODIFIABLE RISK FACTORS FOR STROKE
(2) ACUTE CASES OF STROKE
(3) MAJOR SEQUELAE OF STROKE
They identified the effective health services that are targeted at each of these three dimensions and linked these steps to estimate need for health services. They compared the estimate of need for health services to compiled measures of levels of stroke-related health services in Queens, New York to see if there was a gap (unmet need) or surplus (over met need) of these services.
Risk factors for stroke include heavy alcohol consumption, atrial fibrillation, diabetes, hypercholesterolemia, hypertension, obesity, low physical activity, smoking, ischemic heart disease, and transient ischemic attack. Where might QHPRU get estimates of the incidence of these conditions?
For each risk factor, or stroke sequelae, QHPRU listed the kind of intervention that would be effective, and the proportion of people for whom this intervention would be appropriate. According to Table 4.3, which three interventions are appropriate for hypercholesterolemia, and for what proportion of high-risk individuals?
The following types of interventions were recommended for acute stroke services:
(a)SURGICAL INTERVENTION (CAROTID ENDARTERECTOMY)
(b)IMAGING OF THE BRAIN (CT OR MRI)
(d)NON-INVASIVE IMAGING OF THE VESSELS (ULTRASONOGRAPHY OR MAGNETIC RESONANCE ANGIOGRAPHY)
(e) INVASIVE IMAGING OF THE VESSELS (CEREBRAL ANGIOGRAPHY)
For what percent of at-risk individuals are these services recommended?
AGES 25-44: 30,000 MEN AND 13,000 WOMEN • AGES 45-64: 33,000 MEN AND 42,500 WOMEN
AGES 65 AND ABOVE: 17,000 MEN AND 42,000 WOMEN
How many residents in Queens will need fasting lipoprotein analysis and dietary and pharmacologic interventions for hypercholesterolemia?
What percent of need is not currently being met in Queens?
It is estimated that Queens provides thrombolytic therapy and carotid endarterectomy to 50 and 200 patients respectively. CT and MRI brain imaging is provided to 1,000 and 150 patients respectively. Non-invasive and invasive imaging of the vessels is provided to 425 and 170 patients respectively. Rehabilitation is provided to 1,400 acute stroke survivors, and homecare services are provided to 1,400 chronic stroke with disability patients. What is the level of unmet need in terms of the number of patients not receiving each of recommended services for acute or chronic stroke victims? What percent of need is not currently being met in Queens?
Excerpt from file: CaseStudy3 The Queens Health Policy Research Unit (QHPRU) estimated the need for stroke services in Brooklyn, New York using measures of prevalence and incidence of (1) MODIFIABLE AND NONMODIFIABLE RISK FACTORS FOR STROKE (2) ACUTE CASES OF STROKE (3) MAJOR SEQUELAE OF STROKE They identified the
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