Abstract:
BACKGROUND AND PURPOSE:We evaluated the impact of a primary stroke center (PSC) destination policy in a major metropolitan city and used geographic modeling to evaluate expected changes for a comprehensive stroke center policy. METHODS:We identified suspected stroke emergency medical services encounters from 1/1/2004 to 12/31/2013 in Philadelphia, PA. Transport times were compared before and after initiation of a PSC destination policy on 10/3/2011. Geographic modeling estimated the impact of bypassing the closest hospital for the closest PSC and for the closest comprehensive stroke center. RESULTS:There were 2 326 943 emergency medical services runs during the study period, of which 15 099 had a provider diagnosis of stroke. Bypassing the closest hospital for a PSC was common before the official policy and increased steadily over time. Geographic modeling suggested that bypassing the closest hospital in favor of the closest PSC adds a median of 3.1 minutes to transport time. Bypassing to the closest comprehensive stroke center would add a median of 8.3 minutes. CONCLUSIONS:Within a large metropolitan area, the time cost of routing patients preferentially to PSCs and comprehensive stroke centers is low.
journal_name
Strokejournal_title
Strokeauthors
Mullen MT,Pajerowski W,Messé SR,Mechem CC,Jia J,Abboud M,David G,Carr BG,Band Rdoi
10.1161/STROKEAHA.118.020691subject
Has Abstractpub_date
2018-04-01 00:00:00pages
1021-1023issue
4eissn
0039-2499issn
1524-4628pii
STROKEAHA.118.020691journal_volume
49pub_type
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