Читать книгу Emergency Medical Services - Группа авторов - Страница 416

Studies have shown disparities related to socioeconomic status and stroke patient outcomes. Varying results have been found regarding the probability of ambulance use, prehospital priority levels, prehospital stroke recognition, and generalized prehospital delays. A study conducted in Sweden attempted to ascertain whether prehospital stroke care differs with respect to socioeconomic status. The study looked at multiple factors, including ambulance use, prioritization, and prehospital recognition of stroke. The study included patients who received stroke care at a larger hospital system over an approximate 2‐year time span and who had been transported by ambulance. A neighborhood‐level socioeconomic status was used, defined by the average income and education level for each postal code number in the hospital system catchment area. This study found those stroke patients with a lower socioeconomic status had prolonged prehospital delays, lower probability of receiving the appropriate highest priority level in the ambulance, and a stroke diagnosis that was less likely to be recognized by prehospital clinicians. The median system delay, defined as time from emergency call by patient or bystander until start time of brain CT, was 30 minutes longer in those patients with lower socioeconomic status. Socioeconomic disparities in health care are well‐documented. This particular study points specifically to inequities concerning prehospital care. A delay of 30 minutes could prove significant for the availability and effectiveness of time‐sensitive treatment options [45].