State primary stroke center policies in the United States: rural health issues

Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association
Catherine P SladeEunju Rho

Abstract

To explore the relationship between state primary stroke center (PSC) designation policy implementation and access to optimal stroke care for residents of rural areas. Primary data were collected during the period September 2008-August 2009. Following content analysis of state PSC policies, four case study states were selected for fieldwork, in part for state rural healthcare access challenges. Variables included the barriers and facilitators to PSC designation policy implementation. More than 100 semistructured stakeholder interviews were conducted by teams of researchers. Large-group meetings were also observed. Interview summaries were reviewed by stakeholders for accuracy and completeness. The consistent finding in all study states was that PSC designation and state policy implementation in rural areas are unlikely for a variety of reasons, including lack of financial resources for telemedicine, difficulty maintaining neurology coverage, and emergency departments unable to administer thrombolytics. Findings indicate recognition by states about the need for stroke-care public policy specific to telemedicine in rural areas. Although state PSC designation policies raise awareness of rural issues, designation policy alone canno...Continue Reading

References

Feb 5, 1999·Stroke; a Journal of Cerebral Circulation·S R Levine, M Gorman
Dec 12, 2001·Neurology·W S BurginL B Morgenstern
Oct 7, 2003·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Astrid Knott
Apr 19, 2008·Stroke; a Journal of Cerebral Circulation·Jacques JoubertAllan McLean
Jul 16, 2008·Archives of Neurology·Enrique C LeiraHarold P Adams
Nov 8, 2008·Current Treatment Options in Neurology·R Charles Callison, Enrique C Leira
Apr 15, 2009·Journal of Telemedicine and Telecare·Fuji Lai
May 9, 2009·Stroke; a Journal of Cerebral Circulation·Lee H SchwammUNKNOWN Interdisciplinary Council on Peripheral Vascular Disease
Jun 27, 2009·Cerebrovascular Diseases·Heinrich J Audebert, Lee Schwamm
May 13, 2010·Health Services Research·Rajendra SinghElena V Astapova

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Citations

Nov 30, 2013·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Michael KulcsarMary G George
Sep 8, 2018·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Christopher M SheaSteve North

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