Variation in patterns of telestroke usage during the COVID-19 pandemic

Objectives: Early in the pandemic, there was a substantial increase in telestroke uptake among hospitals. The motiva-tions for using telestroke during the pandemic might have been different than for hospitals that adopted telestroke pre-viously. We compared stroke care at hospitals that adopted telestroke prior to the pandemic to care at hospitals that adopted telestroke during the pandemic. Materials and methods: Stroke episodes and telestroke use were identified in Medicare Fee-for-Service Data. Hospital and episode charac-teristics were compared between pre-pandemic (Jan. 2019-Mar. 2020) and pandemic (Apr. 2020-Dec. 2020) adopters. Results: Hospital bed counts, critical access statuses, stroke volumes, clinical operating margins, shares of stroke care via telestroke, and vascular neurology consult rates did not differ significantly between pre-pandemic and pandemic -adopting hospitals. Hospitals that never adopted telestroke during the study period were more likely to be small critical access hospitals with low clinical operating margins. Conclusions: Compared to hospitals that adopted telestroke before the pandemic, hospitals that adopted telestroke during the pandemic were similar in characteristics and how they used telestroke.(c) 2023 Elsevier Inc. All rights reserved.