Abstract
Introduction: Stroke is a global health concern, with its impact more pronounced in low- and middle-income countries like India. The access to acute stroke treatments, especially intravenour thrombolysis and mechanical thrombectomy, is limited. This research dives into the regional variations in the distribution and accessibility of stroke centers in India. Methods: Data on stroke centers, including those capable of intravenous thrombolysis (IVT) and endovascular treatment (EVT), was gathered from pertinent medication and device providers and geocoded. We estimated driving distances and travel durations between population centers and their proximate IVT and EVT stroke facilities using Google Distance Matrix API, which provided gross estimations. We then compared the estimates across different zones to look at regional disparities in access to stroke facilities. Results: Of the 566 IVT-capable centers spread across 26 states/UTs, 361 (63%) were equipped for EVT. The average stroke centres per million (SCPM) population was 0.41 and 0.26 for IVT-C and EVT-C, respectively. Majority of stroke centres were located in the south zone (>35%), followed by the western and central zones, while the north, east and northeast zones collectively accounted for just 15% of stroke facilities. Median travel distances to IVT and EVT centers were 114 km and 140 km, respectively. Median travel durations to access IVT and EVT facilities stood at 3.04 and 3.46 hours, respectively. The median duration in the south zone for IVT-C and EVT-C centers was 2 and 2.5 Conclusions: The findings of this gross estimations a comprehensive view of stroke care infrastructure in India, highlighting significant regional disparities. The substantial travel times and distinct inconsistencies in stroke care facility availability underscore the need for strategic policy interventions and focused interventions, particularly in underserved regions.
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