Many Americans More Than an Hour Away -- MEDICA - World Forum for Medicine

Many Americans More Than an Hour Away

When stroke strikes, every minute counts: Nearly two million neurons die each minute a stroke is left untreated, making it a race to recognize symptoms so that lifesaving “clot-busting” drugs can be administered.

Less than a quarter of U.S. residents can reach one of the stroke centres in less than a half hour. The authors say the identification of these gaps in access is an important step in cutting the deadly toll of stroke, which is the third leading cause of death and the leading cause of long-term disability in the United States. The study revealed one existing way to narrow these disparities: Using existing air ambulance resources to fly stroke patients to appropriate care would cut the number of Americans without 60-minute access to a primary stroke centre by half.

The new study results showed that overall, fewer than one in four Americans (22 percent) have access to a primary stroke centre within 30 minutes, and just over half (55 percent) can reach one within an hour when ambulances are not permitted to cross state lines. Patients are most able to get to a primary stroke centre by ground within 60 minutes if they live in the Northeast (64 percent), followed by the Midwest (61 percent). In the South and West portions of the country, just over half (52 percent and 51 percent) of patients can reach those advanced facilities within an hour. The addition of air ambulances, however, boosts access substantially: within a half hour, 26 percent of the population could reach a primary stroke centre, and 79 percent could be transported to one within 60 minutes.

In addition to air transport of stroke patients, the authors suggest that lower-cost solutions could also be employed to extend the net of optimal care to a greater number of patients. Among suggestions: the development of inter-hospital referral networks, using telemedical technology to connect smaller or rural hospitals with guidance from specialty physicians trained in stroke care, and offering incentives for the development of stroke centres in underserved areas.; Source: University of Pennsylvania School of Medicine