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Urban-rural differences in the care and outcomes of acute stroke patients: Systematic review


Dwyer, M and Rehman, S and Ottavi, T and Stankovich, J and Gall, S and Peterson, GM and Ford, K and Kinsman, L, Urban-rural differences in the care and outcomes of acute stroke patients: Systematic review, Journal of The Neurological Sciences, 397 pp. 63-74. ISSN 0022-510X (2019) [Refereed Article]

Copyright Statement

Copyright 2018 Elsevier B.V.

DOI: doi:10.1016/j.jns.2018.12.021


Objective: To describe literature pertaining to urban-rural differences in both the quality of care and outcomes of acute stroke patients.

Methods: We systematically searched CINAHL, PubMed, ProQuest Dissertations & Theses, and Scopus for published and unpublished literature until 9th December 2017. Studies were included if they compared the acute care provided to, or outcomes of, patients hospitalised for stroke in urban versus rural settings. Abstract, full-text review, and data extraction were conducted in duplicate. Findings are presented in the form of narrative syntheses.

Results: A total of 28 studies were included in the review (16 on care, 12 on outcomes). With few exceptions, studies addressing the provision of care suggested that rural patients have less access to most aspects of acute stroke care. Studies reporting urban-rural differences in patient outcomes were inconsistent in their findings, however, few of these studies were primarily focused on the issue of urban-rural disparities. Overall, study findings did not appear to differ in line with study quality ratings, stroke subtypes included, or how inter-facility patient transfers were accounted for.

Conclusions: There is convincing, albeit not unanimous, evidence to suggest that stroke patients in rural areas receive less acute care than their urban counterparts. Despite this, the available data and methodology have largely not been used to study urban-rural differences in patient outcomes.

Item Details

Item Type:Refereed Article
Keywords:stroke, urban, rural, care, management, hospital, acute
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Dwyer, M (Dr Mitchell Dwyer)
UTAS Author:Rehman, S (Dr Sabah Rehman)
UTAS Author:Ottavi, T (Mr Thomas Ottavi)
UTAS Author:Gall, S (Associate Professor Seana Gall)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Ford, K (Dr Karen Ford)
UTAS Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:131008
Year Published:2019
Web of Science® Times Cited:16
Deposited By:Pharmacy
Deposited On:2019-02-25
Last Modified:2022-08-23

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