A retrospective analysis in Stroke found that individuals with lower incomes are less likely to seek prompt treatment for a stroke, specifically within 3 hours of stroke symptoms. As a result, these individuals have lower rates of post-stroke care or thrombolysis therapy than their higher-income counterparts. The research team examines the medical records of 11,050 patients who were admitted for either a stroke or transient ischemic attack between July 2003 and March 2008.
Though stroke severity and outcome were similar across income groups, the study indicated that those persons in higher-income groups had a shorter duration between the onset of the stroke and the hospital arrival, as well as higher rates of admission to a stroke unit and more use of thrombolysis for those with ischemic stroke. The rates of discharge to an inpatient rehabilitation unit were similar among income groups also, but those in lower-income groups were less likely to be referred to stroke secondary prevention clinics.
Patients in higher-income groups also had notably more physician visits in the 3-month period following their stroke, as indicated by the study. In terms of occupational therapy, physical therapy, and speech language pathology, there were no significant differences across income groups.
The authors of the study speculate “individuals from lower-income areas could benefit from focused education about stroke warning signs and the importance of timely assessment.” The researchers observe that improved patient outcomes following a stroke have been linked with vascular neurologist and stroke unit care as well as stroke secondary prevention clinics, which provide counseling, education, and monitoring of treatment. As such, the authors add that providers and health care systems should “work to reduce income-related disparities in stroke care.”