Kate Bass BSc
A new study published today reports that a large proportion of the United States would be unable to access primary a stroke centre within one hour by ambulance.
Stroke is a leading cause of death and disability and rapid treatment is essential to minimise damage to the brain and reduce the risk of prolonged disability. Hospitals with the expertise to provide early stroke management have been certified, eg, primary stroke centres, comprehensive stroke centres (the highest level of certification).
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Study author Dr Michael T Mullen explained “Research has shown that specialized stroke care has the potential to reduce death and disability. Stroke is a time-critical disease. Each second after a stroke begins, brain cells die, so it is critically important that specialized stroke care be rapidly accessible.”
Dr Mullen's team used data from 2010 (when there were 811 primary stroke centres but no comprehensive stroke centres in the United States) to estimate the proportion of the population that would be able to access a comprehensive stroke centre within an hour under optimal circumstances. They then assessed how many primary stroke centres would need to be converted to comprehensive stroke centres to provide the necessary coverage.
The results showed that, on average, if each state converted up to 20 well situated primary stroke centres into comprehensive stroke centres, 63% of the population would live within a one-hour drive of a centre and a further 23% would be within a one-hour flight away. However, access in some states was well below the national average so these states would require greater change.
Dr Mukken highlighted “Even under optimal conditions, many people may not have rapid access to comprehensive stroke centres, and without oversight and population level planning, actual systems of care are likely to be substantially worse than these optimized models,”
It is hoped that optimization modelling studies, such as this one, could help policy makers and health planners identify those areas with unmet need. Future efforts can thereby be focussed on ensuring that specialized stroke care is accessible throughout the United States.