To reduce disability and death from stroke, one should be able to arrive in time to acute care centers for strokes. We examined the geographic and demographic inequalities in travel times to major centers for stroke accredited by the Joint Commission (JCPSC, for its acronym in English) and other hospitals where they work initiatives to improve the quality of care for these conditions in North Carolina, South Carolina and Georgia.
We define the limits of the areas located at 30 and 60 minutes away by time management to hospitals and other JCPSC by mapping technology for geographic information systems (GIS) and calculate the proportions of the population in these areas by demographic characteristics. Death rates by age-adjusted stroke county level overlapped areas bounded by time management.
Approximately 55% of the population lived 30 minutes away by car from a JCPSC hospital and 77% to about 60 minutes away. Disparities were found in the percentage of the population living within 30 minutes driving distance by race and ethnicity, education, income and status of urban or rural residence; the disparity was greater in urban areas (70% lived 30 minutes away by car) and rural areas (26%). The coastal plains of rural areas have the highest concentration of counties with high rates of stroke mortality and fewer JCPSC.
Many areas in these three states lack quick access to JSPSC. Alternative strategies are needed to expand the provision of acute medical care services for cerebrovascular accidents in this region. The GIS model is useful for analyzing and strategically plan the distribution of hospitals providing acute care for stroke.