An article published in JAMA Internal Medicine presents an analysis for a national group of Medicare beneficiaries that calculated travel time to evaluate the association of seven-day and 30-day death rates with receiving care in a primary stroke centre (PSC).
Stroke is a leading cause of death and long-term disability in the US. It is believed that PSCs can maximise patient outcomes and are more appropriate in providing disease-specific care. However, this analysis aimed to determine the impact of travel times on outcomes and the potential benefit of admission to a PSC.
The study was conducted between 2010 through 2013 and included 865,184 patients. The average age was around 79. There were 976 PSCs across the country and 53.9 percent patients from the study group were treated at PSCs. Approximately a quarter of these patients lived closer to a PSC than a non-PSC facility.
The analysis suggests that admission to a PSC was associated with a 1.8 percent lower seven-day and 30-day death rate. However, travelling at least 90 minutes to a PSC was found to offset any benefit of care in such a facility. The findings suggest 60 minutes of travel time could offset the benefit of PSC admission for seven day outcomes.
"Further investigations are necessary to identify the best combination of approaches to improve access to centers of excellence and stroke outcomes," the authors conclude.
Source: JAMA Internal Medicine
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