Statewide availability of acute stroke treatment, services, and programs: A survey of North Carolina Hospitals

Patel, Mehul D.; Brown, Anna Bess; Kebede, Essete S.

doi:10.1016/j.jstrokecerebrovasdis.2023.107323

Journal of Stroke and Cerebrovascular Diseases

2023

DOI: 10.1016/j.jstrokecerebrovasdis.2023.107323

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Statewide availability of acute stroke treatment, services, and programs: A survey of North Carolina Hospitals

Mehul D. Patel,

Anna Bess Brown,

Essete S. Kebede

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2024

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Cited by 1 publication

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Rural–urban differences in emergency medical services bypass routing of stroke in North Carolina

Patel,

Chari,

Cui

et al. 2024

The Journal of Rural Health

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PurposeAcute stroke is a serious, time‐sensitive condition requiring immediate medical attention. Emergency medical services (EMS) routing and direct transport of acute stroke patients to stroke centers improves timely access to care. This study aimed to describe EMS stroke routing and transports by rurality in North Carolina (NC).MethodsWe conducted a retrospective study using existing data on EMS transports of suspected stroke patients in NC in 2019. The primary study outcome was EMS bypass of the nearest hospital for transport to a nonnearest hospital, determined by geographic information systems (GIS) analysis. Incident addresses were geocoded to census tracts and classified as urban, suburban, or rural by Rural–Urban Commuting Area codes. We compared the frequency of bypass and estimated additional transport times by urban, suburban, and rural incident locations.FindingsOf 3666 patients, 1884 (51%) EMS transports bypassed the nearest hospital. Bypass occurred less often for rural EMS incidents (39%) compared to those in urban (57%) and suburban (63%) tracts. The estimated additional transport time for rural bypasses of nonendovascular‐capable stroke centers for endovascular‐capable stroke centers was a median of 25 min (interquartile range 13–33).ConclusionsUsing GIS analysis, we found nearly half of EMS transports of suspected stroke patients in NC bypassed the nearest hospital, including noncertified hospitals and stroke centers. Bypasses occurred less often in rural areas, though incurred significantly longer transport times, compared to urban areas. These findings are important for regional stroke system planning, especially for improving rural access to acute stroke care.

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Rural–urban differences in emergency medical services bypass routing of stroke in North Carolina

Patel,

Chari,

Cui

et al. 2024

The Journal of Rural Health

View full text Add to dashboard Cite

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Statewide availability of acute stroke treatment, services, and programs: A survey of North Carolina Hospitals

Cited by 1 publication

References 29 publications

Rural–urban differences in emergency medical services bypass routing of stroke in North Carolina

Rural–urban differences in emergency medical services bypass routing of stroke in North Carolina

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