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. 2021 Oct;11(4):317-325.
doi: 10.1177/19418744211010049. Epub 2021 Apr 20.

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

Matthew E Ehrlich  1 , Bin Han  2 , Michael Lutz  1 , Mohsen Ghiasi Ghorveh  3 , Yasmin Ali Okeefe  1 , Shreyansh Shah  1 , Brad J Kolls  1   3 , Carmelo Graffagnino  1
Affiliations

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

Matthew E Ehrlich et al. Neurohospitalist. 2021 Oct.

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.

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

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Figures

Figure 1.
Figure 1.
Maps of SES Measures by Census Block.
Figure 2.
Figure 2.
EMS Use by Time of Arrival.
See this image and copyright information in PMC

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