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Research Article| Volume 32, ISSUE 1, 106874, January 2023

Evolution of endovascular stroke centers and disparities in access to stroke care in four Northeastern states: 2015-2019

Published:December 02, 2022DOI:https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106874
Evolution of endovascular stroke centers and disparities in access to stroke care in four Northeastern states: 2015-2019
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      Abstract

      Objectives

      Disparities exist throughout our healthcare system, especially related to access to care. Advanced stroke care for strokes is only available at selected endovascular centers (ESCs) in the United States. Although the number of ESCs increase each year, this does not necessarily reflect increased access to care. Here, we look at the evolution of ESC in four states and disparities in access to advanced stroke care.

      Materials and methods

      This is a descriptive study of access to ESCs in four Northeastern states between 2015-2019. Using data from the United States Census Bureau and spatial analysis, we examined the proportion of the population with drive times of less than 60 minutes stratified by income, race/ethnicity, population density, and insurance. We also calculated the mean drive time for each of these socioeconomic groups from their census tracts to the nearest ESC.

      Results

      Between 2015 and 2019, the number of ESCs increased from 15 to 48. The proportion of patients within a 60-minute drive of an ESC increased from 77% to 88%. However, only 66% of the least densely populated quartile lived within 60 min of an ESC. By income, access to ESCs in the wealthiest quartile was 96.6% compared to 83.7% in the lowest quartile. Hispanics and non-Hispanic Blacks had the largest proportions of populations within 60 minutes of an ESC while Non-Hispanic Whites had the smallest.

      Conclusions

      This study underscores the need to evaluate the placement of new ESCs to assure that these hospitals decrease disparities and increase access to advanced stroke care.

      Key Words

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      Article info

      Publication history

      Published online: December 02, 2022
      Accepted: November 2, 2022
      Received in revised form: October 4, 2022
      Received: July 30, 2022

      Footnotes

      Work performed at Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University and Department of Geography, Temple University. This study was partially funded by: Temple University, College of Liberal Arts Student LAURA Award.

      Identification

      DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106874

      Copyright

      © 2022 Elsevier Inc. All rights reserved.

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