Sex Disparities in Access to Stand Alone Primary Stroke Centers: Can Telemedicine Mitigate This Effect? (P2.137)

Objective: To determine if there are health disparities in access to care after implementing telemedicine. Background: We aimed to compare access to acute stroke care between genders in the state of Texas with and without the use of telemedicine (TM). Methods: Texas hospitals were identified from the 2009 American Hospital Association (AHA) Annual Survey. PSC status and TM use were determined from the telephone survey and confirmed by The Joint Commission (TJC) or state list. Hospitals were placed in mutually exclusive categories: stand-alone PSC, PSC using TM (PSC-TM), or a TM capable non-PSC (TM-Only). Access to PSCs was determined by summing the population who could reach a standalone PSC within 60-minutes by ground. We calculated the population who could reach a PSC-TM or TM-Only within 60-minutes. Results: A total of 578 Texas hospitals were identified in the AHA database, of which 96% completed our telephone survey. Nearly 18 million Texans had 60-minute ground access to a stand-alone PSC without TM. PSCs that utilize TM provided 60-minute access for an additional 1.55 million Texans. If the TM-Only centers use their TM cameras for acute stroke care an additional 0.5 million people could have 60-minute access. Women had slightly lower odds of having 60-minute access to a stand alone PSC (OR 0.988, 95%CI 0.983-0.993). However, there is no difference in 60-minute ground access to PSC or PSC-TM between men and women (OR 1.003, 95% CI 0.998-1.007). If existing TM-Only sites were converted to PSC-TM, the odds of providing 60-minute ground access to acute stroke care for those currently without access is no different between men and women (OR 0.995 95% CI 0.989-1.001). Discussion: Our study found no evidence of sex disparities in access to acute stroke care or in potential access to acute stroke care in the state of Texas. Although women had lower odds of access to stand alone PSCs this disparity no longer existed once access via telemedicine was considered. Disclosure: Dr. Wolff has nothing to disclose. Dr. Boehme has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Mullen has nothing to disclose. Dr. Branas has nothing to disclose. Dr. Grotta has received personal compensation for activities with Lundbeck as a consultant. Dr. Savitz has received personal compensation for activities with Celgene, Aldagen, KM Pharmaceutical, and GlaxoSmithKline Inc. Dr. Savitz received research support from Johnson & Johnson, Athersys, Celgene, Genentech Inc., and Aldagen. Dr. Carr has received research support from the Agency for Healthcare Research & Quality, the Center for Disease Control & Prevention, and the National Institutes of Health.