Quality of Stroke Treatment Depends on Where You Live
New research published in the July issue of Stroke suggests that emergency stroke treatment in the United States is wildly inconsistent, leaving many people unnecessarily disabled with long recoveries. The study found that only 4.2 percent of more than 844,000 stroke victims received the drug called tPA, or another urgent stroke treatment. If given in the first hours after a stroke, tPA and other treatments can restore blood flow in the brain and prevent the damage that causes stroke-related disability and drives up the long-term cost of caring for stroke survivors.
To conduct their study, the team looked at Medicare participants who had strokes in each of the nation's 3,436 different hospital markets between 2007 and 2010. They found that in one-fifth of these regions, no patients received the clot-busting drug, tPA. Two of the best performing cities were Stanford, CT and Asheville, NC, where 14 percent of patients received the drug.
The team notes that variation in tPA use did track to lower average levels of education and income and in areas of higher unemployment. However, the top 20 areas for tPA use are scattered across the country, in urban and rural areas, rich and poor ones.
The researchers calculated that if all regions achieved the same rates of tPA use as the Stanford region, more than 92,800 people would get treated, and 8,078 people would survive their stroke disability-free. Even if all regions doubled their current tPA use, 7,206 people would be spared disability.