Emergency Medical Services (EMS)Response and Transport Time for Stroke in an Urban African-American Population: Effect of Socio-demographics of the Patient’s ZIP Code
Introduction: Our hypothesis is that the total time between a 911 call and arrival at the Emergency Department (ED)(EMS time) varies by the socio-demographics of a stroke patient’s ZIP code, controlling for distance to the ED (EMS distance). This study considers an urban African-American (AA) population. Methods: We identified all hospitalized and autopsied strokes/TIAs between 1/1/93 and 6/30/93 for AA residents in the Greater Cincinnati/ Northern Kentucky area. Address and timing of stroke and emergency care were abstracted from the medical chart. We obtained socio-demographic data for the ZIP code of residence from 1990 Census files: income, % AA, % on public assistance, and % below poverty. Location of residence and ED and estimation of EMS distance were calculated using ARCVIEW software. Linear regression was used for analysis. Results: Of 352 strokes, 268 occurred at home, 123 used EMS transport, and 81 had complete time data. Longer EMS time was associated with percent of the residents in the ZIP code on public assistance (p=.03), controlling for EMS distance (p=.02, Table). No other personal or socio-demographic attributes of the ZIP code were significant. Conclusion: ZIP codes with a higher percentage of residents on public assistance had significantly longer EMS times than ZIP codes with a lower percentage. Issues that may influence this relationship will be discussed.