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(Stroke. 2008;39:1920.)
© 2008 American Heart Association, Inc.

Topical Review

Stroke in Rural Areas and Small Communities

Jacques Joubert, MBChB, MD, MRCP, FRACP; Louise F. Prentice, MBBS, FRACP; Thierry Moulin, PhD; Siaw-Teng Liaw, PhD; Lynette B. Joubert, D.Litt et Phil; Pierre-Marie Preux, MD; Dallas Ware; Elizabeth Medeiros de Bustos, MD Allan McLean, PhD, FRACP

From the Division of Neurology, Royal Melbourne Hospital (J.J.); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne (L.F.P.); Faculty Information Unit and School of Rural Health, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne (S.-T.L.); School of Nursing and Social Work, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne (L.B.J.); University of Limoges, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France (P.-M.P.); National Ageing Research Institute, Melbourne (J.J., D.W.), Department of Neurology CHU, Jean Minjoz Hospital, Besancon; University of Franche-Comté (E.M.d.B., T.M.) University of Notre Dame, Melbourne (A.M.).

Correspondence to Jacques Joubert, National Ageing Research Institute, 34 Poplar Rd, Parkville, Vic, Australia 3052. E-mail joubert8{at}bigpond.com

Renee Lyons MD Anthony Rudd MD Section Editors:

Abstract

The management of stroke in rural and regional areas is variable in both the developed and developing world. Informed by best-practice guidelines and recommendations for systems of stroke care, adaptable models of care that are appropriate for local needs should be devised for rural and regional settings. This review addresses the issue of the provision of appropriate services in rural and regional settings, with particular attention to the barriers involved, according to the classification of Low Human Development Country (LHDC), Medium Human Development Country (MHDC) and High Human Development Country (HHDC). We discuss the need and feasibility of developing implementing stroke care in rural settings according to best-practice recommendations, within models of care adapted to local conditions.

Key Words: health care • stroke • stroke care • stroke delivery • rural