Dataset Information

Access to hyperacute stroke services across Canadian provinces: a geospatial analysis.

ABSTRACT:

Background

Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets.

Methods

We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS) base centres to which one can drive in 3.5-6 hours. We calculated the proportional area of each forward sortation area (first 3 digits of the postal code) contained within a drive-time polygon. We applied this ratio to the 2011 Canadian census population of the forward sortation area to estimate the population that can reach a stroke centre in a designated time.

Results

A total of 47.1%-96.4% of Canadians live within a 4.5-hour drive to a stroke centre via road EMS, and 53.3%-96.8% live within a 6-hour drive. Assuming a total travel time of 5 hours by EMS from base centre to patient and patient to hospital, 84.7%-99.8% of the population has access to a current or proposed endovascular thrombectomy site.

Interpretation

Most Canadians live within 6 hours' road access to a stroke centre. Geospatial mapping could be used to inform decisions for additional sites and identify gaps in service accessibility. Coordinated systems of care and ambulance bypass agreements must continue to evolve to ensure maximal access to time-sensitive emergency stroke services.

SUBMITTER: Eswaradass PV

PROVIDER: S-EPMC5510287 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Access to hyperacute stroke services across Canadian provinces: a geospatial analysis.

Eswaradass Prasanna Venkatesan PV Swartz Richard H RH Rosen Jamey J Hill Michael D MD Lindsay M Patrice MP

CMAJ open 20170601 2

<h4>Background</h4>Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets.<h4>Methods</h4>We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS ...[more]

PMID: 28615192

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Dataset Information

Access to hyperacute stroke services across Canadian provinces: a geospatial analysis.

Background

Methods

Results

Interpretation

Publications

Access to hyperacute stroke services across Canadian provinces: a geospatial analysis.

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