Abstract TMP20: Mapping the Expansion of the Minnesota Stroke System of Care

Abstract

Objectives: Stroke is the fifth leading cause of death in Minnesota (MN) and in the United States. The state of MN a has a unique geographical layout with many healthcare facilities located in rural areas. In 2013 legislation was passed authorizing the Minnesota Department of Health to designate hospitals as Acute Stroke Ready Hospitals, Primary Stroke Centers, and Comprehensive Stroke Centers. When a hospital joins the MN Stroke System they maintain vital infrastructure, expertise, and care processes to provide high quality stroke care in accordance with evidence-based guidelines. We used geographic information systems (GIS) methods to visualize the growth and expansion of the Minnesota Stroke System and quantify its reach to Minnesotans across the state over a 10-year period. Methods: Using the Network Analyst extension of ESRI ArcGIS Desktop 10.8.2, 30- and 60- minute drive time service areas were calculated around each designated hospital in 2013, 2017 and 2023. Census block groups were identified where the mean center of population fell within the 30-minute drive time areas and the populations of those block groups were summed. A percentage was calculated using the total Minnesota population as the denominator. Results: In 2013, only 66% of Minnesota’s population lived within 30 minutes of a designated stroke center and 80% lived within a 60-minute drive time. Stroke designated hospitals (19) were largely concentrated in metropolitan areas, leaving many rural Minnesotans without ready access to stroke centers. After the first cycle in 2017, or three-year period post statute, drive time status increased to 90% of the population living within 30 minutes of a designated stroke system hospital and 98% living within a 60- minute drive time. As of 2023, 94% of Minnesotans now live within a 30-minute drive of a designated Stroke System Hospital and 99% live within a 60-minute drive time. Conclusions: Stroke statute was the catalyst for improving stroke care access in MN. The voluntary system of care expanded rapidly from 19 initial hospitals to 119 over a 10-year period. This progress means more than 1.9 million additional Minnesotans now have better access to emergency stroke care.