Abstract HUP16: Disparities In Stroke Care In The Metro Detroit Area

Abstract

Introduction: According to the AHA, approximately 795,000 people suffer a stroke per year. Studies have also shown that people with a lower socioeconomic status (SES) have a higher mortality rate at 1 year following a stroke. Rehabilitation is fundamental to stroke recovery but requires adequate access to health care and support systems. Patient with lower socioeconomic status may not have adequate access to health care or the support systems leading to delays in transfer to rehabilitation centers, longer hospital stays, increased complication rates, and poorer outcomes. Hypothesis: Patients with lower SES have longer hospital stays and are more likely to be discharged home rather than to inpatient rehabilitation centers. Methods: Retrospective observational cohort study of 744 patients discharged from Neurology units with primary diagnosis of acute ischemic stroke. Patients were grouped by zip code into bottom 50 median household income (lower SES) and top 50 median household income (higher SES). Income data was obtained from the United States Census Bureau. Results: Fewer patients with lower SES were discharged by hospital day 5 compared to those with higher SES (58% vs. 68%). Additionally, more patients with lower SES were discharged home rather than to a rehabilitation center after hospital day 5 (15% vs. 7%). Conclusion: Those from communities with lower SES had longer hospital stays and were less likely to be discharged to rehabilitation centers after longer hospital stays. Longer hospital stays suggests those with lower SES encounter obstacles that prevent and even preclude transfer to rehabilitation centers. Larger studies should be performed to identify and ameliorate factors that limit access to proper post-stroke care such as adequate rehabilitation.