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Socioeconomic disparities in prehospital stroke care.
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg.
Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.ORCID-id: 0000-0003-4139-6235
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg.
2019 (Engelska)Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 27, nr 1, artikel-id 53Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
2019. Vol. 27, nr 1, artikel-id 53
Nyckelord [en]
Education, Income, Prehospital delay, Stroke, Transient ischaemic attack
Nationell ämneskategori
Neurologi
Forskningsämne
Människan i vården
Identifikatorer
URN: urn:nbn:se:hb:diva-22162DOI: 10.1186/s13049-019-0630-6ISI: 000466937800001PubMedID: 31046804Scopus ID: 2-s2.0-85065260443OAI: oai:DiVA.org:hb-22162DiVA, id: diva2:1376432
Tillgänglig från: 2019-12-09 Skapad: 2019-12-09 Senast uppdaterad: 2019-12-20Bibliografiskt granskad

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