Abstract P169: Assessing Racial Disparity in Emergency Medical Transport of Suspected Stroke Patients

Abstract

Introduction: Numerous studies have found evidence of disparities in the treatment and health outcomes of patients with acute ischemic stroke. As minimizing time to treatment is essential in acute ischemic stroke management, we aimed to assess for racial disparities in emergency stroke transport. Emergency transport times are dependent on the geographic distribution of patients and hospitals, but previous studies have not controlled for racial variation in spatial distributions when assessing for disparity. Methods: Using a novel dataset of 2,518 unique entries with detailed spatial and temporal information on all suspected stroke transports conducted by a public emergency medical service in Central Texas over eight years, we conducted one-way ANOVA tests with post-hoc pairwise t-tests to assess how mean hospital transport time varied by patient race and developed a spatially-independent metric of emergency transport urgency. Results: Results are reported as means with standard errors and p-values from post-hoc pairwise testing. We found that mean transport time to a hospital was 2.5 minutes shorter for black patients (10.9 +/- 0.274 minutes) compared to white patients (13.4 +/- 0.174 minutes) with p < 0.0001. However, white patients’ transport times to a hospital were found to be, on average, 4.1 +/- 0.085 minutes shorter than expected compared to 3.4 +/- 0.124 minutes shorter than expected for black patients (p = 0.00015). Using a novel transport urgency index, we demonstrate that these findings represent race-based variation in spatial distributions rather than racial bias in emergency medical transport. Conclusion: In summary, these results highlight the importance of closely examining spatial distributions when utilizing spatial data to investigate geographically-dependent research questions.