JAMA Neurol: Changes in Stroke Diagnosis and Treatment in Rural and Urban America - 2008-2017

Over the past decade, investments in stroke treatment and care have significantly improved the opportunities and quality of care for stroke patients in rural areasRecently, researchers compared differences in medical treatment, care and patient outcomes in rural and urban patients with acute ischemic stroke or transient cerebral ischemic attacksstudy looked at Data for Medicare claims in the United States for 2008-2017, including all rural and urban areas, including a total of 4.01 million patients with transient ischemic attacks or acute strokes who lived in urban or rural areas and were hospitalized for transient ischemic attacks or acute strokeThe main endpoints of the study were discharge from a certified stroke center, neurologic consultation sat, treated with atepase, days of hospitalization and 90 days of mortalitythe final sample included 3.47 million patients, of which 2.01 million (58.0%) were women, with an average age of 78.6 yearsIn 2008, 24,681 patients (25.2 per cent) and 161,217 (60.6 per cent) were treated in accredited stroke centres in both rural and urban areas (the gap was -35.4 per cent)By 2017, the gap was -26.6 per cent, a narrowing of 8.7 per centDuring admission, the urban-rural gap assessed by neurologists was also narrowing (6.3 per cent), while the gap between urban and rural areas in receiving atepase treatment (0.5 per cent), admission (0.5 days) and 90-day mortality (0.3 per cent) widened or similarstudies suggest that over the past decade, more and more rural patients with acute ischemic stroke and transient cerebral ischemic attacks have received certified professional treatment, but gaps in access to soto syllables (such as atepase) and treatment outcomes remain