Abstract 78: Mobile Stroke Units Address Disparities in Stroke Care as Demonstrated by Zip Code Level Socioeconomic Status

Abstract

Introduction: Acute ischemic stroke (AIS) disproportionately affects minority populations with evidence showing black and Hispanic patients utilize traditional EMS less, have greater delay in arrival to the emergency department, are less likely to receive thrombolysis, and have lower odds for good functional outcomes. 1–3 Mobile Stroke Units (MSUs) bring diagnostic and treatment tools for AIS directly to patients, achieving faster thrombolytic administration and better outcomes. 4,5 Objective: This study compared demographic data and used Census data to characterize the socioeconomics of patient zip codes served and transported by our MSU based in Rochester, NY relative to patients that arrived at our institution via traditional EMS and private vehicle. Methods: Data was extracted from the 2018 American Community Survey (ACS), a 5-year a rolling survey of the US population. Zip code level socioeconomic status (zSES) was calculated based on 5 key factors by assigning percentile ranks to each across all US zip codes and combined to create one index variable measuring zSES. zSES, its factors, and demographics were compared amongst MSU and non-MSU patients. Results: 468 patients transported by our MSUs to our institution between October 2018 to January 2022 were compared to the 2,296 non-MSU patients for the same time-period. Patients transported by MSU lived in zip codes with significantly lower SES Index (0.482 versus 0.527, p=0.013). Component analysis showed that MSU patients came from zip codes with a higher percentage of households with single parents, higher percentage of individuals below the federal poverty line, higher percentage of unemployed individuals, and higher percentage of adults with less than a 12 th grade education. Per capita income did not differ. In addition, patients transported by our MSU’s were significantly more female, black, and Hispanic. Age did not differ. Conclusion: Mobile Stroke Units (MSU) help address disparities in stroke care, by bringing care to patients who live in zip codes that have significantly lower SES and are of historically marginalized communities, compared to patients transported by EMS and private vehicle.