Stroke Certification Less Likely in the Most Disadvantaged Communities

TUESDAY, July 30, 2024 (HealthDay News) -- Hospitals located in the most disadvantaged communities have a lower likelihood of adopting any stroke certification, according to a study published online July 25 in JAMA Network Open.

Renee Y. Hsia, M.D., from the University of California in San Francisco, and colleagues conducted a cohort study to examine whether hospitals in socioeconomically disadvantaged communities are less likely to adopt stroke certification using newly collected stroke center data. A total of 5,055 hospitals were studied from 2009 to 2022, of which 47.8, 11.9, and 40.3 percent never achieved stroke certification, were certified as acute stroke-ready hospitals, and were certified as primary stroke centers or higher, respectively.

The researchers found that adoption of any stroke certification was most likely to occur near the most advantaged communities and was least likely near the most disadvantaged communities compared with mixed-advantage communities (hazard ratios, 1.24 and 0.43, respectively). Mixed-advantage communities were most likely to have adoption of acute stroke-ready certification, while adoption of higher-level certification was more likely in the most advantaged communities and least likely in the most disadvantaged communities (hazard ratios, 1.41 and 0.31, respectively). The stroke certification adoption hazard was lower for relatively disadvantaged communities and for the most disadvantaged communities compared with mixed-advantage communities (adjusted hazard ratios, 0.80 and 0.58, respectively), after adjustment for population size and hospital capacity.

"Given increasing evidence showing that stroke-certified hospitals are associated with improved care, incentivizing and providing support for hospitals in disadvantaged communities to obtain stroke certification may serve as an important strategy for reducing stroke disparities," the authors write.

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