Evidence map›Paper›PMID 41819511›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2026

Racial and ethnic disparities in access to acute stroke capabilities in California: Association with rurality and telestroke access.

Kori S Zachrison, Renee Y Hsia, Krislyn M Boggs, Jingya Gao, Luke Messac, Lee H Schwamm, Mathew J Reeves, Vicki Fung, Margaret E Samuels-Kalow, Carlos A Camargo

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

10 authors.

Kori S ZachrisonDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: kzachrison@mgh.harvard.edu.
Renee Y HsiaDepartment of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA.
Krislyn M BoggsDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Jingya GaoDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Luke MessacHarvard Medical School, Boston, MA, USA; Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA, USA.
Lee H SchwammDepartments of Neurology and Biomedical Informatics & Data Sciences, Yale School of Medicine, New Haven, CT, USA.
Mathew J ReevesDepartment of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
Vicki FungHarvard Medical School, Boston, MA, USA; Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA, USA.
Margaret E Samuels-KalowDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

Funding

Addressing Racial/Ethnic Disparities in Stroke Care Access Using Hospital Transfer NetworksR01AG079887 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI Korilyn Sauser Zachrison · 2023 to 2026
$2.9M
NIA NIH HHS R01 AG079887
6 · The paper itself

Abstract

backgroundWe sought to examine the relationship between patient race/ethnicity and presentation to an emergency department (ED) with acute stroke capabilities, and whether this varied by rurality and telestroke access.

methodsAll acute ischemic stroke encounters in California in 2021 were obtained from California Department of Health Care Access and Information data. ED capabilities were from the 2021 National ED Inventory-USA database. Acute stroke capability was defined as having acute stroke ready status (or higher), telestroke or both. We examined the association between race/ethnicity and presentation to an ED with acute stroke capabilities, overall and stratified by rurality. Sensitivity analyses removed telestroke from our definition of acute stroke capability.

resultsIn 2021, 264 of 325 California EDs (81%) had acute stroke capabilities, 41 (13%) via telestroke alone. Only 2,050 of 63,252 encounters (3%) presented to an ED without capabilities. Rural (versus urban) patients had lower odds of access to acute stroke capabilities, regardless of telestroke status. There were no differences in access by race/ethnicity for rural patients, but urban Hispanic, non-Hispanic Black and patients of other race had lower odds of access (versus urban non-Hispanic Whites) regardless of telestroke status.

conclusionsMost California EDs have acute stroke capabilities. While few patients presented to non-capable centers, rural patients had lower odds of access. Racial/ethnic disparities differed between urban and rural settings, with lower odds of access for Hispanic and non-White urban patients but no significant differences by race/ethnicity in rural patients, however this latter finding might reflect limited power due to smaller sample sizes. ED telestroke capability did not reduce disparities in access.

Indexed as

Emergency Service, HospitalHealthcare DisparitiesHealth Services AccessibilityIschemic StrokeRural HealthRural Health ServicesStrokeTelemedicineAgedAged, 80 and overCaliforniaDatabases, FactualFemaleHumansMaleMiddle AgedAccess to careAcute strokeRacial/ethnic disparitiesRural disparitiesTelestroke

Identifiers

PMID41819511
PMCPMC13043215

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.