Abstract Details

Title Bridging the Rural-urban Divide in Stroke Care: Evaluating Statewide Accessibility and Distribution in Oklahoma

Topic Global Health and Neuroepidemiology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 20-007

Objective This study aims to evaluate the accessibility of acute stroke care across Oklahoma, identifying geographic and resource-based disparities that disproportionately affect rural populations, with the goal of developing strategies to achieve statewide, equitable stroke care access.

Background Stroke is a time sensitive medical emergency requiring rapid diagnosis and treatment. However, access to specialized care remains uneven across Oklahoma. Rural regions face the greatest disadvantage due to the unequal distribution of comprehensive stroke centers and limited availability of advanced interventions, leaving rural residents without access to timely, lifesaving reperfusion therapies.

Design/Methods Stroke related resources and population accessibility were assessed across all hospitals in Oklahoma. Each hospital’s geographic coordinates were obtained using Google Maps, and catchment areas were defined by a 30-minute driving radius using Openrouteservice, which generates isochrones, polygonal boundaries representing areas reachable within the established time frame. Rural–Urban Commuting Area (RUCA) codes were used for urban-rural classification. Travel distances to the nearest three hospitals able to provide acute reperfusion therapy were calculated using Google Maps.

Results A total of 164 hospitals were identified: per 2020 RUCA codes 50.6% (83) were urban, 48.2% (79) rural, and 1.2% (2) unknown (excluded from analysis). Only 17.7% had stroke certification, mainly concentrated in Oklahoma City and Tulsa, although certification rate did not differ significantly by rurality (16.9% rural vs 19.0% urban, p=0.839). Among urban facilities, Comprehensive Stroke Centers predominated (53.3%) whereas rural hospitals were primarily Acute Stroke Ready Centers (53.3%). Thrombectomy availability differed significantly: 0 rural (0.0%) vs 10 urban (12.7%), Fisher p=0.0006335.

Conclusions These findings highlight the persistent rural urban divide in stroke care across Oklahoma. Expanding telemedicine networks, optimizing EMS triage and transfer protocols, exploring cross state collaboration, and strategically developing new stroke centers guided by spatial modeling tools such as the MAPSTROKE project are critical to improve statewide stroke care equity.

Authors/Disclosures
Daniela Mercado, MD PRESENTER	Dr. Mercado has nothing to disclose.
Leonardo Carbonera	Leonardo Carbonera has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allm. The institution of Leonardo Carbonera has received research support from World Stroke Organization . The institution of Leonardo Carbonera has received research support from Boehringer Ingelheim.
Melba Zuniga Gutierrez, MD	Dr. Zuniga Gutierrez has nothing to disclose.
María Cedeño-Bruzual, MD	Dr. Cedeño-Bruzual has nothing to disclose.
Ana Claudia De Souza	Ana Claudia De Souza has nothing to disclose.
Briana Liu	Ms. Liu has nothing to disclose.
Hang Lee, PhD	Dr. Lee has nothing to disclose.
Laura Boada Robayo, MD	Laura Boada Robayo, MD has nothing to disclose.
Leonardo d. Dorneles, MSc	Mr. Dorneles has received research support from CAPES.
Mateus Boiani	Mr. Boiani has nothing to disclose.
Marcio Dorn, Sr., PhD	Prof. Dorn has nothing to disclose.
André d. Frainer	Mr. Frainer has received research support from CNPQ. An immediate family member of Mr. Frainer has received personal compensation in the range of $500-$4,999 for serving as a fiscal auditor with PREVIC. An immediate family member of Mr. Frainer has received personal compensation in the range of $500-$4,999 for serving as a IT technician with Caixa Econômica Federal. An immediate family member of Mr. Frainer has received personal compensation in the range of $500-$4,999 for serving as a fiscal auditor with Receita Federal.
Maria do Carmo d. Martins, PhD	Dr. Martins has nothing to disclose.
Daniel Vizcaya, MsC	Mr. Vizcaya has nothing to disclose.
Hyatt Saleh	Mrs. Saleh has nothing to disclose.
Camila Bonin Pinto (Oklahoma University)	Camila Bonin Pinto has nothing to disclose.
Faddi G. Saleh Velez, MD (University of oklahoma health Sciences center)	Dr. Saleh Velez has nothing to disclose.

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