Rural-urban differences in acute stroke management practices: a modifiable disparity

Enrique C Leira; David C Hess; James C Torner; Harold P Adams Jr

doi:10.1001/archneur.65.7.887

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Rural-urban differences in acute stroke management practices: a modifiable disparity

Journal article

Open access

Peer reviewed

Rural-urban differences in acute stroke management practices: a modifiable disparity

Enrique C Leira, David C Hess, James C Torner and Harold P Adams Jr

Archives of neurology (Chicago), Vol.65(7), pp.887-891

07/2008

DOI: 10.1001/archneur.65.7.887

PMID: 18625855

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https://doi.org/10.1001/archneur.65.7.887View

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Abstract

Acute stroke management practices in rural areas of the United States are suboptimal, which creates an unacceptable health disparity between urban patients with stroke and their rural counterparts. The existing gap between urban and rural stroke care may widen in the future as more urban-tested interventions are incorporated into the treatment of acute stroke. We conducted a PubMed search to identify all the articles published from 1997 to 2007 that addressed acute stroke, paramedics, ambulances, emergency services, and interhospital transportation pertaining to the US rural, urban, or nonurban environment. We review herein the problems and potential solutions that exist in 3 aspects of the current rural stroke care system: prehospital care, rural local hospital emergency department care, and interhospital transfer of patients and subsequent reception at a larger tertiary care institution, which often involve long distances and considerable time. We conclude that the current gap in rural-urban stroke management practices could be overcome with a comprehensive strategy that addresses the existing issues, including further education of rural caregivers, remote support from tertiary care institutions, and implementation of future acute clinical trials that test the rural strategies to stroke care.

Humans

Stroke - economics

Socioeconomic Factors

Delivery of Health Care - standards

Delivery of Health Care - economics

Healthcare Disparities - economics

Delivery of Health Care - methods

Healthcare Disparities - methods

Healthcare Disparities - standards

Stroke - epidemiology

Disease Management

Rural Health - standards

Urban Health - standards

Stroke - therapy

Details

Title: Subtitle: Rural-urban differences in acute stroke management practices: a modifiable disparity
Creators: Enrique C Leira - Department of Neurology, 2147-RCP, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242, USA. enrique-leira@uiowa.edu
David C Hess
James C Torner
Harold P Adams Jr
Resource Type: Journal article
Publication Details: Archives of neurology (Chicago), Vol.65(7), pp.887-891
DOI: 10.1001/archneur.65.7.887
PMID: 18625855
NLM abbreviation: Arch Neurol
ISSN: 0003-9942
eISSN: 1538-3687
Publisher: American Medical Association; United States
Grant note: 5K12RR017700-04 / NCRR NIH HHS
Language: English
Date published: 07/2008
Academic Unit: Neurology; Epidemiology; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983995156802771

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