You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 65 No. 7, July 2008 TABLE OF CONTENTS
  Archives
  •  Online Features
  Neurological Review
 This Article
 •Full text
 •PDF
 • Reply to article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Contact me when this article is cited
 Related Content
 •Related article
 •Similar articles in this journal
 Topic Collections
 •Emergency Medicine
 •Medical Practice, Other
 •Cerebrovascular Disease
 •Stroke
 •Alert me on articles by topic

Rural-Urban Differences in Acute Stroke Management Practices

A Modifiable Disparity

Enrique C. Leira, MD, MS; David C. Hess, MD; James C. Torner, PhD; Harold P. Adams Jr, MD

Arch Neurol. 2008;65(7):887-891.

Acute stroke management practices in rural areas of the United States are suboptimal, which creates an unacceptable health disparity between urban patients with stroke and their rural counterparts. The existing gap between urban and rural stroke care may widen in the future as more urban-tested interventions are incorporated into the treatment of acute stroke. We conducted a PubMed search to identify all the articles published from 1997 to 2007 that addressed acute stroke, paramedics, ambulances, emergency services, and interhospital transportation pertaining to the US rural, urban, or nonurban environment. We review herein the problems and potential solutions that exist in 3 aspects of the current rural stroke care system: prehospital care, rural local hospital emergency department care, and interhospital transfer of patients and subsequent reception at a larger tertiary care institution, which often involve long distances and considerable time. We conclude that the current gap in rural-urban stroke management practices could be overcome with a comprehensive strategy that addresses the existing issues, including further education of rural caregivers, remote support from tertiary care institutions, and implementation of future acute clinical trials that test the rural strategies to stroke care.


Author Affiliations: Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Roy J. and Lucille A. Carver College of Medicine (Drs Leira and Adams), and Department of Epidemiology, College of Public Health (Dr Torner), University of Iowa, Iowa City; and Department of Neurology, Medical College of Georgia, Augusta (Dr Hess).


RELATED ARTICLE

This Month in Archives of Neurology
Arch Neurol. 2008;65(7):871-872.
FULL TEXT  






HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2008 American Medical Association. All Rights Reserved.