Racial Impact on Inpatient Stroke Quality of Care in Two Community Hospitals

Area of Science:

• Neurology
• Public Health
• Health Disparities Research

Background:

• Quality improvement initiatives are crucial for identifying and addressing racial disparities in stroke care.
• Understanding pre-hospital care differences is essential for optimizing the stroke chain of survival.

Purpose of the Study:

• To analyze racial disparities in inpatient stroke quality of care.
• To compare pre-hospital and in-hospital stroke care between white and non-white patient groups.

Main Methods:

• Utilized the Get With The Guidelines (GWTG) database for stroke patient encounters in 2021.
• Conducted supplemental chart review for accurate racial/ethnic categorization.
• Compared white and non-white patient groups using univariate analysis.

Main Results:

• Non-white patients, though younger, experienced longer hospital arrival times and less frequent ambulance use.
• In acute ischemic stroke (AIS) and transient ischemic attack (TIA) cohorts, non-white patients had delayed hospital arrival and lower IV thrombolysis rates.
• In-hospital quality metrics, including door-to-CT and door-to-needle times, were similar between racial groups.

Conclusions:

• Significant racial disparities exist in the pre-hospital phase of stroke care, negatively impacting treatment utilization.
• Younger non-white patients exhibit poorer health indicators, suggesting a need for early preventative care interventions.
• Addressing pre-hospital delays and improving preventative care are critical for reducing stroke outcome disparities.