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Disparities in Inter-Hospital Helicopter Transport

J Stroke Cerebrovasc Dis; ePub 2018 Dec 11; Sarrazin, et al

There is a disparity in the use of helicopter emergency medical services (HEMS) in Hispanic stroke patients compared to non-Hispanic whites (NHW), according to a recent study. Such a disparity may delay arrival to a mechanical thrombectomy (MT)-capable hospital, delay treatment times, or lead to ineligibility for MT altogether. Acute ischemic stroke patients emergently transferred to another facility were identified in a retrospective review of a large Medicare claims database. Mode of transportation (HEMS, advanced, or basic ground ambulances) was determined and distance from patient's residence to the closest center with MT capabilities was calculated. Researchers found:

  • A total of 8,027 patients that underwent emergent inter-hospital transportation were analyzed.
  • HEMS utilization was 18.1% for non-Hispanic blacks (NHB), 20.6% for Hispanics, and 21.6% for NHW.
  • In adjusted analyses for confounders, including distance to a MT-capable hospital, Hispanic patients were less likely than NHWs to be transported by HEMS.
  • While that association had marginal significance for the whole US, it was statistically significant for patients living in the southern region of the US.

Citation:

Sarrazin MV, Limaye K, Samaniego EA, et al. Disparities in inter-hospital helicopter transportation for Hispanics by geographic region: A threat to fairness in the era of thrombectomy. [Published online ahead of print December 11, 2018]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2018.10.031.