HealthDay News — Hospitals in low-income and rural communities have a lower likelihood of receiving stroke care certification, according to a study published online June 27 in JAMA Neurology.
Yu-Chu Shen, Ph.D., from the Naval Postgraduate School in Monterey, California, and colleagues examined differences in hospitals’ likelihood of adopting stroke care certification between historically underserved and general communities. A dataset of hospital stroke certification from all general acute nonfederal hospitals in the continental United States from Jan. 1, 2009, to Dec. 31, 2019, was combined with national, hospital, and census data to define historically undeserved communities. Data were included for 4,984 hospitals.
The researchers found that the total number of hospitals with stroke certification increased from 961 to 1,763 in 2009 to 2019. The highest hazard of adopting stroke care certification was seen for hospitals serving Black, racially segregated communities (hazard ratio, 1.67) in models not accounting for population size, while the hazard was significantly lower among those serving non-Black, racially segregated communities in models controlling for population and hospital size (hazard ratio, 0.74). In low- versus high-income communities, the adoption hazard was lower, regardless of the level of economic segregation; relative to urban hospitals, rural hospitals were less likely to adopt any level of stroke care certification (hazard ratio, 0.43).
“Our findings suggest that structural inequities in stroke care may be an important consideration in eliminating stroke disparities for vulnerable populations,” the authors write.