ArticlePloS one2018
Rural versus urban academic hospital mortality following stroke in Canada.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- A Randomized Control Trial of a Virtually Delivered Program for Increasing Upper Limb Activity After Stroke.Neurorehabilitation and neural repair · 2025Trial
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- Rural Emergency 360°: A mixed-methods analysis of barriers and priorities for equitable emergency care in Québec.PloS one · 2026Article
- Disparities in Access to Vascular Stroke Imaging and Carotid Revascularization: A Population Study.Journal of the American Heart Association · 2025Article
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- Through the big top: An exploratory study of circus-based artistic knowledge translation in rural healthcare services, Québec, Canada.PloS one · 2024Article
- Computer-aided diagnosis of chest X-ray for COVID-19 diagnosis in external validation study by radiologists with and without deep learning system.Scientific reports · 2023Article
- Relationship between perceptions of recurrence risk and depression state among first-episode ischemic stroke patients in rural areas: The mediating role of coping style.Nursing open · 2023Article
- An Age-Stratified Cross-Sectional Study of Physical Activity and Exercise Adherence of Stroke Survivors in Rural Regions.Patient preference and adherence · 2023Article
- Predicting DWI-FLAIR mismatch on NCCT: the role of artificial intelligence in hyperacute decision making.Frontiers in neurology · 2023Article
- Observational
- Article
- Potentially avoidable inter-facility transfer from Veterans Health Administration emergency departments: A cohort study.BMC health services research · 2020Observational
- A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care.Future healthcare journal · 2020Article
- Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study.BMC emergency medicine · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionStroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada.
objectivesTo describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. MATERIALS AND
methodsWe included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate.
resultsA total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities.
conclusionRural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada's universal health care system.
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