Abstract P247: Geographic Disparities in Access to Outpatient Stroke Rehabilitation Centers

Abstract

Outpatient stroke rehabilitation centers (OSRC) play a vital role in providing post-discharge care essential for stroke survivors’ optimum recovery. However, with the ongoing pandemic, reduced access to outpatient stroke rehab has become a serious concern, particularly for stroke survivors residing in rural areas. Key aim: Examine access to OSRC across micropolitan and non-core rural counties in southeastern Texas. Method: We systematically identified OSRC in rural southeast Texas by performing an internet search. A telephonic survey was administered to collect data on OSRC. Estimated stroke incidence and discharge status were extracted from claims databases. Google maps determined travel distance and time. Descriptive statistics were used to examine and compare the characteristics of rural counties. Analyses were performed using SAS® 9.2. Results: We surveyed 65 OSRC from a total of 42 rural (12 micropolitan and 30 non-core) southeast Texas counties (Fig 1). Over 50% non-core counties had no access to OSRC; number of centers per 1000 stroke patients was 4.7 (non-core) versus 11.0 (micropolitan) (P=0.01) (Table 1) . Compared to micropolitan areas, fewer centers in non-core rural areas offered physical therapy, occupational therapy, speech-language therapy. Telerehabilitation is also far less available in rural non-core counties than micropolitan counties (table 1). Survivors from non-core counties need to travel twice the distance to access OSRC. Stroke incidence, however, remains high in non-core versus micropolitan areas ( Fig 1). Conclusion: In conclusion, non-core rural counties in southeast Texas have inferior access to OSRC despite a high need for post-stroke care. During the pandemic, when patients remain at home, urgent efforts such as telerehabilitation are needed to improve access to these critical services to improve rural stroke survivor outcomes.