Mobile Stroke Units Address Socioeconomic Disparities in Care.

Abstract

Background and objectives: Strokes disproportionately affect underprivileged populations. Mobile stroke units (MSUs) bring diagnostic and treatment tools for stroke directly to patients. This study assessed how MSUs in Rochester, New York, address disparities in stroke care.

Methods: This observational study compared demographics and ZIP code socioeconomic status (zSES) of patients transported by our MSUs in Rochester, New York, relative to stroke patients who arrived at our institution by traditional emergency medical service and private means.

Results: Between October 2018 and January 2022, 468 stroke patients were transported by our MSU and 2296 stroke patients presented to our institution by traditional emergency medical service or private transport. Patients transported by the MSU had significantly lower overall zSES. Moreover, MSU patients resided in ZIP codes with higher percentages of population below the federal poverty line, single parent households, unemployment, and adult residents without a 12th grade education. In addition, MSU-transported patients were more frequently Black, female, and of Hispanic ethnicity. Age and per capita income did not differ between the two groups, but presenting stroke scale for MSU patients was significantly higher than non-MSU patients. For MSU patients, 86% received onboard computed tomography and 18% received onboard thrombolytic therapy. The median time from dispatch to scene, computed tomography slice, and thrombolytic therapy were 10, 24, and 43 minutes, respectively.

Conclusion: MSU help address disparities in stroke care by bringing care to stroke patients who live in ZIP codes that have significantly lower zSES and are of historically underprivileged communities.