ArticleThe Lancet regional health. Western Pacific2022
The impact of ethnicity on stroke care access and patient outcomes: a New Zealand nationwide observational study.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Pooled it
- Ethnicity and health-related quality of life in the post stroke population: a systematic review.Journal of rehabilitation medicine · 2025Pooled it
- Preference-based measures of health-related quality of life in Indigenous people: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Pooled it
- Epidemiology and determinants of cardiovascular disease in Indigenous populations.Nature reviews. Cardiology · 2026Review
- Ethnic disparities in health-related quality of life and cognitive function after stroke in the Netherlands.Health and quality of life outcomes · 2026Article
- Stroke care in indigenous populations: A World Stroke Organization (WSO) scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Article
- The impact of inpatient and community stroke rehabilitation on health-related quality of life in New Zealand.European journal of physical and rehabilitation medicine · 2025Observational
- A multiperspective investigation of the underrepresentation of minoritized ethnic participants in dementia research and proposed strategies to improve inclusive recruitment practices.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Trends in stroke incidence, death, and disability outcomes in a multi-ethnic population: Auckland regional community stroke studies (1981-2022).The Lancet regional health. Western Pacific · 2025Article
- Trends in Ethnic Disparities in Stroke Care and Long-Term Outcomes.JAMA network open · 2025Article
- Addressing disparities in the global epidemiology of stroke.Nature reviews. Neurology · 2024Review
- Biographical continuation: recovery of stroke survivors and their family caregivers in Taiwan.Primary health care research & development · 2024Article
- Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database.Frontiers in neurology · 2024Article
- Pre-hospital telestroke and expanded hyper-acute telestroke network solutions to reduce geographic inequities: a brief review from the South Pacific.Frontiers in stroke · 2024Review
- Ethnic differences in stroke outcomes in Aotearoa New Zealand: A national linkage study.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Tino rangatiratanga - a rural Māori community's response to stroke: 'I'm an invalid but I'm not invalid'.Journal of the Royal Society of New Zealand · 2023Review
- Stroke among Māori in Aotearoa New Zealand and solutions to address persistent inequities.Frontiers in stroke · 2023Review
- Attaining Health Equity in New Zealand and the World.The Lancet regional health. Western Pacific · 2022Article
- An Association Test for Ordinal Outcomes in Clustered Data With Informative Cluster Size.Pharmaceutical statisticsArticle
Corrections and comments
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Authors and funding
17 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEthnic inequities in stroke care access have been reported internationally but the impact on outcomes remains unclear. In New Zealand, data on ethnic stroke inequities and resultant effects on outcomes are generally limited and conflicting.
methodsIn a prospective, nationwide, multi-centre observational study, we recruited consecutive adult patients with confirmed stroke from 28 hospitals between 1 May and 31 October 2018. Patient outcomes: favourable functional outcomes (modified Rankin Scale 0-2); quality of life (EQ-5D-3L); stroke/vascular events; and death at three, six and 12 months. Process measures: access to reperfusion therapies, stroke-units, investigations, secondary prevention, rehabilitation. Multivariate regression analyses assessed associations between ethnicity and outcomes and process measures.
findingsThe cohort comprised 2,379 patients (median age 78 (IQR 66-85); 51·2% male; 76·7% European, 11·5% Māori, 4·8% Pacific peoples, 4·8% Asian). Non-Europeans were younger, had more risk factors, had reduced access to acute stroke units (aOR=0·78, 95%CI, 0·60-0·97), and were less likely to receive a swallow screen within 24 hours of arrival (aOR=0·72, 0·53-0·99) or MRI imaging (OR=0·66, 0·52-0·85). Māori were less frequently prescribed anticoagulants (OR=0·68, 0·47-0·98). Pacific peoples received greater risk factor counselling. Fewer non-Europeans had a favourable mRS score at three (aOR=0·67, 0·47-0·96), six (aOR=0·63, 0·40-0·98) and 12 months (aOR=0·56, 0·36-0·88), and more Māori had died by 12 months (aOR=1·76, 1·07-2·89).
interpretationNon-Europeans, especially Māori, had poorer access to key stroke interventions and experience poorer outcomes. Further optimisation of stroke care targeting high-priority populations are needed to achieve equity.
fundingNew Zealand Health Research Council (HRC17/037).
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