Literature DB >> 34567392

Socioeconomic Influence on Emergency Medical Services Utilization for Acute Stroke: Think Nationally, Act Locally.

Matthew E Ehrlich1, Bin Han2, Michael Lutz1, Mohsen Ghiasi Ghorveh3, Yasmin Ali Okeefe1, Shreyansh Shah1, Brad J Kolls1,3, Carmelo Graffagnino1.   

Abstract

BACKGROUND AND
PURPOSE: Rates of emergency medical services (EMS) utilization for acute stroke remain low nationwide, despite the time-sensitive nature of the disease. Prior research suggests several demographic and social factors are associated with EMS use. We sought to evaluate which demographic or socioeconomic factors are associated with EMS utilization in our region, thereby informing future education efforts.
METHODS: We performed a retrospective analysis of patients for whom the stroke code system was activated at 2 hospitals in our region. Univariate and logistic regression analysis was performed to identify factors associated with use of EMS versus private vehicle.
RESULTS: EMS use was lower in patients who were younger, had higher income, were married, more educated and in those who identified as Hispanic. Those arriving by EMS had significantly faster arrival to code, arrival to imaging, and arrival to thrombolytic treatment times.
CONCLUSION: Analysis of regional data can identify specific populations underutilizing EMS services for acute stroke symptoms. Factors effecting EMS utilization varies by region and this information may be useful for targeted education programs promoting EMS use for acute stroke symptoms. EMS use results in more rapid evaluation and treatment of stroke patients.
© The Author(s) 2021.

Entities:  

Keywords:  emergency medical services; epidemiology; quality; socioeconomic status; stroke and cerebrovascular diseases

Year:  2021        PMID: 34567392      PMCID: PMC8442147          DOI: 10.1177/19418744211010049

Source DB:  PubMed          Journal:  Neurohospitalist        ISSN: 1941-8744


  37 in total

1.  National trends in ambulance use by patients with stroke, 1997-2008.

Authors:  Hooman Kamel; Babak B Navi; Jahan Fahimi
Journal:  JAMA       Date:  2012-03-14       Impact factor: 56.272

2.  Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials.

Authors:  Kennedy R Lees; Erich Bluhmki; Rüdiger von Kummer; Thomas G Brott; Danilo Toni; James C Grotta; Gregory W Albers; Markku Kaste; John R Marler; Scott A Hamilton; Barbara C Tilley; Stephen M Davis; Geoffrey A Donnan; Werner Hacke; Kathryn Allen; Jochen Mau; Dieter Meier; Gregory del Zoppo; D A De Silva; K S Butcher; M W Parsons; P A Barber; C Levi; C Bladin; G Byrnes
Journal:  Lancet       Date:  2010-05-15       Impact factor: 79.321

3.  Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging.

Authors:  Gregory W Albers; Michael P Marks; Stephanie Kemp; Soren Christensen; Jenny P Tsai; Santiago Ortega-Gutierrez; Ryan A McTaggart; Michel T Torbey; May Kim-Tenser; Thabele Leslie-Mazwi; Amrou Sarraj; Scott E Kasner; Sameer A Ansari; Sharon D Yeatts; Scott Hamilton; Michael Mlynash; Jeremy J Heit; Greg Zaharchuk; Sun Kim; Janice Carrozzella; Yuko Y Palesch; Andrew M Demchuk; Roland Bammer; Philip W Lavori; Joseph P Broderick; Maarten G Lansberg
Journal:  N Engl J Med       Date:  2018-01-24       Impact factor: 91.245

4.  Strategies used by hospitals to improve speed of tissue-type plasminogen activator treatment in acute ischemic stroke.

Authors:  Ying Xian; Eric E Smith; Xin Zhao; Eric D Peterson; DaiWai M Olson; Adrian F Hernandez; Deepak L Bhatt; Jeffrey L Saver; Lee H Schwamm; Gregg C Fonarow
Journal:  Stroke       Date:  2014-04-08       Impact factor: 7.914

5.  Determinants of use of emergency medical services in a population with stroke symptoms: the Second Delay in Accessing Stroke Healthcare (DASH II) Study.

Authors:  E B Schroeder; W D Rosamond; D L Morris; K R Evenson; A R Hinn
Journal:  Stroke       Date:  2000-11       Impact factor: 7.914

6.  Understanding reasons for delay in seeking acute stroke care in an underserved urban population.

Authors:  Amie W Hsia; Amanda Castle; Jeffrey J Wing; Dorothy F Edwards; Nina C Brown; Tara M Higgins; Jasmine L Wallace; Sara S Koslosky; M Chris Gibbons; Brisa N Sánchez; Ali Fokar; Nawar Shara; Lewis B Morgenstern; Chelsea S Kidwell
Journal:  Stroke       Date:  2011-05-05       Impact factor: 7.914

7.  Neighborhood Influences on Emergency Medical Services Use for Acute Stroke: A Population-Based Cross-sectional Study.

Authors:  William J Meurer; Deborah A Levine; Kevin A Kerber; Darin B Zahuranec; James Burke; Jonggyu Baek; Brisa Sánchez; Melinda A Smith; Lewis B Morgenstern; Lynda D Lisabeth
Journal:  Ann Emerg Med       Date:  2015-09-16       Impact factor: 5.721

8.  Birth and adult residence in the Stroke Belt independently predict stroke mortality.

Authors:  M Maria Glymour; Anna Kosheleva; Bernadette Boden-Albala
Journal:  Neurology       Date:  2009-12-01       Impact factor: 9.910

9.  Barriers and disparities in emergency medical services 911 calls for stroke symptoms in the United States adult population: 2009 BRFSS Survey.

Authors:  Munseok Seo; Charles Begley; James R Langabeer; Jami L DelliFraine
Journal:  West J Emerg Med       Date:  2014-03

Review 10.  Socioeconomic status and stroke: an updated review.

Authors:  Juliet Addo; Luis Ayerbe; Keerthi M Mohan; Siobhan Crichton; Anita Sheldenkar; Ruoling Chen; Charles D A Wolfe; Christopher McKevitt
Journal:  Stroke       Date:  2012-02-23       Impact factor: 7.914

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