Socioeconomic disparities in prehospital stroke care.

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  • Author(s): Niklasson A;Niklasson A; Herlitz J; Herlitz J; Jood K; Jood K
  • Source:
    Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2019 May 02; Vol. 27 (1), pp. 53. Date of Electronic Publication: 2019 May 02.
  • Publication Type:
    Journal Article; Multicenter Study
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101477511 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-7241 (Electronic) Linking ISSN: 17577241 NLM ISO Abbreviation: Scand J Trauma Resusc Emerg Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central
    • Subject Terms:
      Registries*; Emergency Medical Services/*methods ; Healthcare Disparities/*economics ; Stroke/*therapy; Adult ; Female ; Hospitalization/trends ; Humans ; Male ; Middle Aged ; Socioeconomic Factors ; Stroke/economics ; Stroke/epidemiology ; Sweden/epidemiology ; Young Adult
    • Abstract:
      Background and Purpose: Recent studies have revealed socioeconomic disparities in stroke outcomes. Here, we investigated whether prehospital stroke care differs with respect to socioeconomic status (SES).
      Methods: Consecutive stroke and TIA patients (n = 3006) admitted to stroke units at Sahlgrenska University Hospital, Gothenburg, Sweden, from 1 November 2014 to 31 July 2016, were included. Data on prehospital care were obtained from a local stroke register. Socioeconomic status was classified according to the average level of income and education within each patient's neighbourhood (postcode area).
      Results: The median system delay from calling the emergency medical communication centre (EMCC) to start of brain computed tomography on hospital arrival was 3 h 47 min (95% confidence interval (CI) 3 h 30 min to 4 h 05 min) for patients within the lowest SES tertile and 3 h 17 min (95% CI 3 h 00 min to 3 h 37 min) for the highest tertile (p < 0.05). Patients with a lower SES were less likely to receive the highest priority in the ambulance (p < 0.05) and had lower rates of prehospital recognition of stroke/TIA (p < 0.05) than those with a high SES. No inequities were found concerning EMCC prioritisation or the probability of ambulance transport.
      Conclusions: We found socioeconomic inequities in prehospital stroke care which could affect the efficacy of acute stroke treatment. The ambulance nurses' ability to recognise stroke/TIA may partly explain the observed inequities.
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    • Grant Information:
      N/A Västra Götalandsregionen; N/A Stroke Centre West; N/A Rune och Ulla Amlövs Stiftelse för Neurologisk och Reumatologisk Forskning; N/A John och Brit Wennerströms Stiftelse för Neurologisk Forskning; N/A Insamlingsstiftelsen för neurologisk forskning; N/A Peter Eriksson's Foundation; N/A Stiftelsen Erik and Lily Philipsons Minnesfond
    • Contributed Indexing:
      Keywords: Education; Income; Prehospital delay; Stroke; Transient ischaemic attack
    • Publication Date:
      Date Created: 20190504 Date Completed: 20190610 Latest Revision: 20200225
    • Publication Date:
      20240628
    • Accession Number:
      PMC6498576
    • Accession Number:
      10.1186/s13049-019-0630-6
    • Accession Number:
      31046804