Published Online
on April 17, 2008

A more recent version of this article appeared on June 1, 2008

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Submitted on August 10, 2007
Revised on October 24, 2007
Accepted on November 21, 2007

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; and 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.).

^* To whom correspondence should be addressed. E-mail: joubert8{at}bigpond.com.

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