Changes in Proportion of International Patients Attending An Urban Stroke Service Over 10 Years

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Abstract Background The population of Ireland has become increasingly ethnically diverse. St James’s Hospital is a large inner-city hospital with a diverse multi-ethnic catchment and, because of its location, also admits quite a large number of tourists and international visitors. About 30% of the population of the St James’s catchment were not born in Ireland. We evaluated the effect of this in 2014 and repeated the study in 2024 to determine the how this has changed over the succeeding decade. Methods We reviewed admissions with primary or secondary diagnoses of ischaemic stroke or primary intracerebral haemorrhage (ICD 10 i61 or i63) over 4-year periods, identified by HIPE. Data for the period 2010-2013 were compared with that for the period 2020-2023. Data were confirmed from patient records. International patients (non-Irish/UK) were identified, and demographic details noted. Results Between 2010 and 2013 there were 1550 admission of which 62 (4.0%) were international. Between 2020 and 2023 1266 patients were admitted of which 101 (8.0%) were international (Chi Sq 19.5, p<0.0001). Mean age of the international population increased from 52 to 56 years over the period compared to an increase from 71 to 73 for the indigenous population. Mean length of stay (LoS) for the international population had reduced for international patients (2010-13: 20.9 days. 2020-23: 12.2 days. Between 2020 and 2023, LoS was significantly shorter for the international than the indigenous population (Mean LoS 12.2 days, vs. 19.6 days, p<0.0003 t test). The international population had a higher proportion of males (67.3% vs. 53.9%, Chi Sq 6.8, p=0.009). Conclusion Over the 10-year period the number of international patients admitted doubled. As a proportion of admissions, they remain low and represent a lower proportion than in the community. Length of stay of international stroke patients is lower and there are a higher proportion of males.