دورية أكاديمية
Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina.
| العنوان: | Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina. |
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| المؤلفون: | Patel MD; Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Chari SV; Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Cui ER; Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Fernandez AR; ESO, Inc., Austin, Texas, USA., Planey AM; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Jauch EC; Department of Research, University of North Carolina Health Sciences at Mountain Area Health Education Center, Asheville, North Carolina, USA., Winslow JE; Department of Emergency Medicine, Wake Forest University, Winston Salem, North Carolina, USA. |
| المصدر: | The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2024 Jul 25. Date of Electronic Publication: 2024 Jul 25. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Country of Publication: England NLM ID: 8508122 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1748-0361 (Electronic) Linking ISSN: 0890765X NLM ISO Abbreviation: J Rural Health Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: [Oxford, Eng.] : Blackwell Original Publication: [Burlington, Vt.?] : Journal of Rural Health, c1985- |
| مستخلص: | Purpose: Acute stroke is a serious, time-sensitive condition requiring immediate medical attention. Emergency medical services (EMS) routing and direct transport of acute stroke patients to stroke centers improves timely access to care. This study aimed to describe EMS stroke routing and transports by rurality in North Carolina (NC). Methods: We conducted a retrospective study using existing data on EMS transports of suspected stroke patients in NC in 2019. The primary study outcome was EMS bypass of the nearest hospital for transport to a nonnearest hospital, determined by geographic information systems (GIS) analysis. Incident addresses were geocoded to census tracts and classified as urban, suburban, or rural by Rural-Urban Commuting Area codes. We compared the frequency of bypass and estimated additional transport times by urban, suburban, and rural incident locations. Findings: Of 3666 patients, 1884 (51%) EMS transports bypassed the nearest hospital. Bypass occurred less often for rural EMS incidents (39%) compared to those in urban (57%) and suburban (63%) tracts. The estimated additional transport time for rural bypasses of nonendovascular-capable stroke centers for endovascular-capable stroke centers was a median of 25 min (interquartile range 13-33). Conclusions: Using GIS analysis, we found nearly half of EMS transports of suspected stroke patients in NC bypassed the nearest hospital, including noncertified hospitals and stroke centers. Bypasses occurred less often in rural areas, though incurred significantly longer transport times, compared to urban areas. These findings are important for regional stroke system planning, especially for improving rural access to acute stroke care. (© 2024 National Rural Health Association.) |
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| معلومات مُعتمدة: | KL2 TR002490 United States TR NCATS NIH HHS; KL2TR002490 United States TR NCATS NIH HHS; R01MD018031 United States MD NIMHD NIH HHS |
| فهرسة مساهمة: | Keywords: emergency medical services; rural; stroke; transport |
| تواريخ الأحداث: | Date Created: 20240726 Latest Revision: 20240727 |
| رمز التحديث: | 20240727 |
| DOI: | 10.1111/jrh.12868 |
| PMID: | 39054674 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1748-0361 |
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| DOI: | 10.1111/jrh.12868 |