Introduction: As access to timely, optimal treatment for acute stroke is associated with lower stroke mortality, understanding the relative access to acute stroke care at a certified primary and/or comprehensive stroke center (CPCSC) is essential for the development of a statewide system of care. The present study aims to describe this access, in relation to the relative burden of stroke mortality in California.
Hypothesis: It is hypothesized that: (1) Overall, in California, access to CPCSCs is relatively high; and (2) Californians who reside in areas with the highest stroke mortality rates have less access to CPCSCs than do those who reside in areas with the lowest stroke mortality rates.
Methods: Using ArcView, a map was created, showing the location of each of the 171 Joint Commission CPCSCs in California, the geographic area within a 40 minute drive-time of each center, and the underlying relative stroke mortality rate in each service area.
Results: Overall, 92% of Californians live within a 40 minute drive of a CPCSC. Further, while 98% of those who live in the least burdensome areas (in terms of stroke mortality) have access to such a center, only 65% of those who live in the most burdensome areas have this kind of access. Two geographic examples of this latter situation include California’s Central Valley and the most northern counties.
Conclusions: It is incumbent upon California’s public health and emergency medical systems to ensure that all Californians have access to high quality acute stroke care at CPCSCs, especially as clinical standards of care advance. Utilizing GIS technology can help identify potential service gaps and inform ongoing and future efforts to ensure this access.