Influence of Socioeconomic Status on Distance Traveled and Care After Stroke

Abstract

Background and Purpose-Vital to maintaining an efficient delivery of services is an understanding of patient travel patterns during an acute ischemic stroke. Socioeconomic status may influence access to stroke care, including transportation and admission to different facility types. Key Words: accessibility Ⅲ health services Ⅲ stroke I n the past 2 decades, there has been an unprecedented increase in population age, bringing an increased burden of stroke and the need for efficient high-quality health care delivery. 1,2 Escalating levels of organized stroke care have been shown to significantly improve patient outcome. 3,4 Unfortunately, these interventions are often limited to larger and more comprehensive stroke centers. 5,6 Thus, it is important to identify whether patients' selection of stroke care facilities is based on proximity or level of expertise and resource, and how this travel is affected by socioeconomic status (SES) and ambulance use. A better understanding of patient flow would help determine whether care required matches care provided and how to optimally allocate public resource.We examined the association between SES and travel patterns during a stroke. Secondarily, we examined the association between patient demographics, ambulance use, hospital expertise, and community type on travel patterns. We hypothesized that patients with low SES receive care at the nearest and less specialized hospital. Materials and Methods Study Design and Data SourcesWe conducted a retrospective study using the Discharge Abstract Database, a mandatory reporting national database using information on all hospitalizations at acute care institutions across all provinces, except Quebec.

Travel Burden and the Direct Medical Costs of Urologic Surgery

“…Previous studies demonstrated decisions for treatment at the closest or a more distant medical center are determined by a variety of factors: desire for treatment at centers with high surgeon and hospital volumes, option to avoid centers with perceived quality care differences, motivation for aggressive treatment, and travel distance considerations. 4,17,18 Our study compliments these by asserting that whatever the patients' motivation to travel further for their care, the distance they travel will not increase their hospital costs or length of stay.…”

Gaps and Hurdles Deter against Following Stroke Guidelines for Thrombolytic Therapy in Iran: Exploring the Problem

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Disparities in Accessibility of Certified Primary Stroke Centers

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