At the Hospitals: Dartmouth-Hitchcock Researchers Find More Specialists Means Fewer Stroke Deaths

D-H Researchers:
More Specialists,
Fewer Stroke Deaths

Lebanon — A team of researchers at Dartmouth-Hitchcock has found an association in the United States between a higher density of neurologists and neurosurgeons and a decreased risk of death from stroke. Neurosurgery resident Dr. Atman Desai led the study, which was recently published by the Journal of Neurosurgery.

For the study, Desai worked with neurosurgeon Perry Ball and fellow neurosurgery resident Kimon Bekelis, analyzing data from the Area Resource File 2009-2010. The database contains county-level information on health care facilities and their utilization and expenditures, health care professionals and their training, and socioeconomic and environmental characteristics.

The researchers examined 3,141 U.S. counties, with the primary outcome variable being the average number of deaths from cerebrovascular disease per million people for each county for the years 2004 through 2006. The primary independent variable was the density of neuroscience providers (the combined number of neurologists and neurosurgeons per million people) in 2006.

In an unadjusted analysis, the researchers found that an increase of one neuroscience provider per million people was associated with 0.71 fewer deaths due to stroke per million people. In a multivariate analysis, in which adjustments were made for county urbanicity,

socioeconomic conditions and the density of general practitioners, an increase of one neurologist or neurosurgeon was associated with 0.38 fewer deaths from stroke per million people.

Rural settings were associated with a significant increase in stroke-related deaths. (The majority of counties studied, 2,051, were classified as rural.)

Neurosurgeons are generally concentrated in and around cities that house tertiary care hospitals, so there’s a large disparity in the density of neuroscience providers throughout counties in the United States, Desai said in a news release last week. “Timely diagnosis and intervention depend on the immediate availability of both neurologists and neurosurgeons, and this is extremely important in stroke cases.”

Stroke is a leading cause of death and disability in the United States. Given the association between the distribution of neuroscience providers and stroke-related deaths, the researchers concluded that the availability of local neurologists and neurosurgeons may be important for the overall likelihood of surviving a stroke, and therefore specialist education and practice should be promoted throughout the U.S.

“The study highlights the key role that specialist providers can play in improving public health outcomes,” Desai said. “While the role of generalists has quite rightly received a lot of attention, the role of specialists has received relatively little. This research adds to the ongoing discussion about the need to establish optimal manpower and resource allocation in health care.”

New London Hospital
Employees Honored

New London — Two employees of New London Hospital were recently honored for their work.

Tina Walker, director of Child Care Services for the hospital’s ABCs Child Care Center, was one of three people in the state to receive the 2012 Excellence in Child Care Award from Early Learning NH.

Early Learning NH works to help New Hampshire children reach their full potential by expanding access to affordable quality child care and early education.

Each year, the nonprofit recognizes professionals in the field of early childhood education for outstanding dedication and commitment to helping children achieve their potential.

Walker was nominated by her employees for her many contributions to the field. In a recent news release, the hospital said Walker “continually strives to provide the highest quality services and support to parents, children and staff ... and is known for her innovative ways in initiating hospital, community and center-based projects.” Walker and the other recipients were honored at a reception at Gov. John Lynch’s office.

The Sunapee resident has worked at the hospital for more than two decades.

Griffin Manning, an advanced practice registered nurse in the hospital’s family practice, received the 2012 Mid-level Clinician Preceptor of the Year Award from the School of Physician Assistant Studies at the Massachusetts College of Pharmacy and Health Sciences-Manchester/Worcester.

The School of Physician Assistant Studies depends on clinicians in practice to provide experiential training to students throughout their education. Each year preceptors are nominated by students, and the award recipients are selected by faculty members. Manning, a preceptor for eight years, was honored with the award in recognition of his dedication to educating students and his philosophy of patient care.

A resident of Warner, N.H., he has been a part of the family practice for ten years. Manning earned his bachelor and master’s degrees at the University of New Hampshire in Durham.

New Staff Join
Valley Regional Healthcare

Claremont — Three new employees have joined Valley Regional Healthcare.

Scott R. Schafer, of Littleton, N.H., has joined Valley Regional Hospital as a clinical systems analyst. His responsibilities include training and assisting clinical staff in the use of the hospital’s electronic medical records and other computerized systems and applications in the inpatient and outpatient areas. He previously held a similar position at Cottage Hospital in Woodsville. Schafer earned a degree in computer science from St. Petersburg (Fl.) College and is a Microsoft Certified Professional and a Cisco Certified Network and Design Associate.

Valley Regional’s new director of physician practices is Elizabeth “Lisa” Vogler. Before joining Valley Regional, Vogler served as practice administrator for the Children’s Medical Group Division of Children’s Hospital of the King’s Daughters in Norfolk, Va. Vogler holds a master’s degree in health administration from Virginia Commonwealth University and a bachelor’s degree from Old Dominion University, which is also in Virginia. She is a member of the Medical Group Management Association and the American Academy of Professional Coders. She and her family will live in Lebanon.

Shelly Bragg, of Canaan, is Valley Regional Hospital’s new director of human resources. She has more than 15 years of experience in business, with a focus on human resource leadership, benefits administration and staff development. Most recently, Bragg served as director of human resources with Global Resource Options in White River Junction. She is a member of the Society of Human Resource Management, the Northeast Human Resource Association and the National Association of Professional Women.

New Employees Join HCRS

Several new employees recently joined Health Care and Rehabilitation Services of Southeastern Vermont.

Tracy Thompson, clinician; James Dixon, community outreach specialist; and Ashley Hutton, intern, recently joined the Hartford office. Janet Allison, an employment specialist; Crystal Goode, a student assistance professional; and Mark Gedmin and Hans Wendlandt, community outreach specialists, have joined the Springfield, Vt., office.

Travis Rowe, a residential specialist supervisor, will work from the Bellows Falls site, and medical assistant Lisa Bomba from the Brattleboro office.

The nonprofit community mental health agency serves residents of Windham and Windsor Counties.

— Compiled by Aimee Caruso