Reasons why few patients with acute stroke receive tissue plasminogen activator

Kara Z. Bambauer, S. Claiborne Johnston, Derek E. Bambauer, Justin A. Zivin

Research output: Contribution to journalReview articlepeer-review

100 Scopus citations


Despite the US Food and Drug Administration's approval in 1996, tissue plasminogen activator (tPA) therapy for acute ischemic stroke remains substantially underused. We reviewed 3 potential reasons for low rates of tPA use: poor patient education, physicians' perceived risk of legal liability from negative patient outcomes, and insufficient reimbursement. The recent addition of diagnosis-related grouping code 559 will provide higher payment for stroke patients treated with tPA, creating a natural experiment to examine our third reason.

Original languageEnglish (US)
Pages (from-to)661-664
Number of pages4
JournalArchives of Neurology
Issue number5
StatePublished - May 2006

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology


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