Healthcare Contexts

Adding healthcare system context substantially improved prediction performance. The cross-country design supports adaptation to diverse systems and varied population needs. Area-level social determinants added little predictive improvement beyond healthcare system context. The project includes Sweden, Latvia, and the Netherlands as countries with different healthcare systems and substantial stroke incidence. Most contextual variables were measured at the beneficiary level, while county-level measures were used for market structure and area-level social determinants. All three participating countries have inequalities in stroke care. Healthcare delivery context included provider, facility, and market variables linked from external CMS and claims-based data sources.