An essential aspect of stroke care is prompt treatment after symptom onset, but systemic issues and biases can correlate with suboptimal triage and treatment. Assessing and targeting quality control to address these sources of disparity can help community and academic hospitals provide more equitable treatment to patients suffering from stroke.

We retrospectively collected data from the electronic health record at Tufts Medical Center for adult patients hospitalized with AIS between 2018-2020. We compared patients who directly presented to TMC with patients transferred from CH for further care. We performed multivariate analyses to assess whether there were disparities underlying differences in door-to-CT and door-to-needle time, method of transportation used, and stroke code activation.

There are disparities in EMS utilization and stroke code activation among patients of different race/ethnicity and who speak a non-English primary language presenting at community and academic medical hospitals. Additional research is needed to assess community and hospital interventions that can diminish the role that systemic biases play in these disparities.