The MAPSTROKE project: A computational strategy to improve access to acute stroke care

Area of Science:

• Computational health
• Geospatial analysis
• Public health policy

Background:

• Global access to acute stroke treatment is uneven, with significant disparities in low and middle-income countries (LMICs), especially in rural regions.
• Standardized methods are needed to assess stroke center coverage and identify optimal locations for new facilities.

Purpose of the Study:

• To develop and implement computational strategies (CSs) for determining optimal locations for new acute stroke centers (ASCs).
• To pilot these CSs in nine Latin American regions/countries to improve acute ischemic stroke (AIS) treatment access.

Main Methods:

• Hospitals meeting criteria for acute stroke centers (ASCs) and potential acute stroke centers (PASCs) were identified using infrastructure and treatment data.
• Geolocation data, drive times (45-min radius), and population density were analyzed using OpenStreetMap and Kontur Population datasets.
• CSs were applied to assess current population coverage and propose new ASCs or artificial points (APs) to achieve 95% target population coverage (TPC).

Main Results:

• Significant disparities in stroke center coverage were observed, with no region achieving 95% TPC using existing or potential centers alone.
• The proposal of artificial points (APs) was necessary to meet the TPC, with 132 new centers suggested for Rio Grande do Sul, Brazil.
• Existing ASCs are concentrated in urban areas, leaving rural populations underserved.

Conclusions:

• The MAPSTROKE project offers a systematic approach to identify underserved areas for acute stroke treatment.
• The developed strategies can guide the placement of new facilities to increase access to acute ischemic stroke care.