Disparities in Access to Stroke Centers in the Southeastern US
Author Information
Author(s): Khan Jenna A., Casper Michele, George Mary, Williams G. Ishmael Jr, Schieb Linda, Greer Sophia, Asimos Andrew W., Clarkson Lydia, Fehrs Laura J., Enright Dianne, Heidari Khosrow, Huston Sara L., Mettam Laurie H.
Primary Institution: Centers for Disease Control and Prevention
Hypothesis
What are the geographic and sociodemographic disparities in drive times to Joint Commission–certified primary stroke centers in North Carolina, South Carolina, and Georgia?
Conclusion
Many areas in this tri-state region lack timely access to JCPSCs, indicating a need for alternative strategies to improve acute stroke care.
Supporting Evidence
- Approximately 55% of the population lived within a 30-minute drive time to a JCPSC.
- 77% of the population lived within a 60-minute drive time to a JCPSC.
- Disparities in access were found based on race/ethnicity, education, income, and urban/rural status.
- Only 26% of people living in rural areas had access to a JCPSC within 30 minutes.
- Counties with high stroke death rates were often outside the 30-minute drive-time areas.
- Most JCPSCs were located in urban areas along the Interstate 85 corridor.
- Many hospitals participating in stroke care quality initiatives were near areas with high stroke death rates.
- GIS modeling effectively illustrated disparities in access to stroke care.
Takeaway
Some people in North Carolina, South Carolina, and Georgia have to travel a long time to get to hospitals that can help with strokes, especially in rural areas.
Methodology
Drive-time analysis using GIS mapping technology to assess population access to JCPSCs and hospitals participating in stroke care quality improvement programs.
Potential Biases
Potential overestimation of stroke service capabilities by hospitals relying on self-reported data.
Limitations
Drive-time analyses may not account for terrain elevation or emergency medical service speed, and death certificate data may introduce geographic reporting bias.
Participant Demographics
The study population included 20,247,778 individuals from North Carolina, South Carolina, and Georgia, with variations by age, race, education, and urban/rural status.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.001
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