People in the US who live in poor, rural, or primarily black communities have less access to stroke centres compared to people who live elsewhere, a new study suggests.
“These findings provide empirical evidence that the provision of acute neurological services is structurally inequitable across historically underserved communities,” wrote Renee Y. Hsia, the senior author of the paper.
The research, published in JAMA Neurology, combined a set of data of hospital stroke certification from 4984 hospitals in the US from January 2009 to December 2019.
In order to identify the various communities, researchers used census data to define historically underserved groups by racial and ethnic composition, income distribution and rurality.
The data collected showed that rural communities are 43 per cent less likely to be certified as a stroke centre than other hospitals in urban and suburban areas.
In regards to black and racially segregated communities, the data was more complex.
“Hospitals serving Black, racially segregated communities,” the paper stated, “had the highest hazard of adopting stroke care certification in models not accounting for population size, but their hazard was 26 per cent lower than among those serving non-Black, racially segregated communities in models controlling for population and hospital size.”
In other words, patients in black and racially segregated communities have the best geographic access which however clashes with the level of stroke care supply.
“While disparities in stroke outcomes are partially due to disparities in stroke audience, another potential reason for these widening disparities is the built environment of health care supply and geographic distribution of services,” wrote researchers.
“Developing a better understanding of structural disparities underlying stroke care differences could inform administrative and policy changes that affect the geographical distribution of care within the stroke care system.”
The researchers concluded “the results suggest that it might be necessary to incentivise hospitals operating in underserved communities to seek stroke certification or to entice hospitals with higher propensity to adopt stroke care to operate in such communities so access at the per-patient level becomes more equitable.”
The findings of the study provided evidence of inequalities across historically underserved communities.
