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Time is a Factor: GIS and Stroke Care in the Veteran Health Administration

Litt ER, Jia H, Cowper Ripley DC, Phipps MS, Wang X, Harnar J, Vogel WB, Graham G. Time is a Factor: GIS and Stroke Care in the Veteran Health Administration. Paper presented at: Esri Health GIS Annual Conference; 2012 Aug 20; Scottsdale, AZ.


Background: American Stroke Association guidelines state the best outcomes after ischemic stroke onset occur when patients receive tissue plasminogen activator (tPA) as soon as possible. Objective: To determine existing coverage of VHA stroke patients within 60 minutes of a VHA hospital and ascertain the additional coverage if non-VHA Stroke Centers were included. Methods: Acute VHA stroke patients hospitalized from 2006-2010 were identified and aggregated to ZIP Code. Network Analyst was used to draw 60 minute travel times around each VHA hospital and non-VHA Stroke Centers. Findings: VHA facilities provided 70% coverage within 60 minutes travel time. By adding Non-VHA Stroke Centers, coverage rose dramatically. For example, in the Southeast region, VHA-only hospitals covered 63% of stroke patients; adding Non-Veteran facilities increased coverage to 83%. Conclusion: To assure that Veterans who suffer a stroke get appropriate care and the best outcomes, partnerships with non-VHA providers may be an avenue to pursue.

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