Stroke patients are facing unequal care on the NHS, with older people less likely to receive a brain scan and white people less likely to be admitted to specialist units than black people, researchers say.
A study published in the British Medical Journal found “significant inequalities” when it comes to accessing stroke care.
Experts, including from King’s College London, analysed data for more than 3,800 patients from south London from between 1995 and 2009.
They found black patients were 76% more likely to be admitted to a dedicated stroke unit than white patients. They were also more likely to receive occupational therapy or physiotherapy, regardless of the severity of their stroke or their age.
The odds of brain imaging were lowest in patients aged 75 and over, and in those of lower socio-economic status. Older patients were more likely to receive occupational therapy or physiotherapy.
The authors said evidence showed all patients would benefit from admission to a dedicated stroke unit.
“This study found that black patients and those with motor or swallowing deficits are more likely to be admitted to a stroke unit, yet the justification for the decision-making is not evidence-based.”
The authors said it was true that older patients are more likely to die before a scan can be carried out.
“It is, however, important to ensure that elderly patients are not excluded deliberately, as lower rates of brain imaging have implications in delivering effective acute treatment as well as the initiation of secondary prevention measures that could possibly result in poorer outcomes.”
The authors concluded: “The findings of this study suggest a disproportionate access to interventions in this population despite a government goal of universal access to healthcare.”
- Addo J, et al. Provision of acute stroke care and associated factors in a multiethnic population: prospective study with the South London Stroke Register. BMJ: Advance online publication.
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