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Abstract

The purpose of this research is to discover and
subsequently implement methods for

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improving the stroke outcome in rural areas. This
review includes disparities in rural areas,

treatments, and the use of technology to improve the
quality of care in these areas.

 

Introduction

Many rural communities
lack adequate access to primary healthcare. 
According to the

Mississippi Department of Health, Mississippi ranked
close to last in ever health outcome

(Mississippi State Department of Health, 2017).  The American Stroke Association reported

Strokes were the number 5 killer in Mississippi in
2015.  Over 1,734 people died of a stroke
in

2015 (America Heart Association, 2015). Rural areas in
Mississippi have slimmer access to

quality health care. 
Even more, there are very few Neurologists across the state of
Mississippi to

treat these patients.   A major problem across
the state of Mississippi is inadequate health care in

the rural areas. 

            The
use of technology can bridge the gap from rural underserved communities to

 Primary Stroke
Care hospitals. Telestroke is the use of interactive videoconferencing to provide

assessment of the patient’s physical condition and
neuroimaging studies.  Specialists are

provided
with time critical information to aid in lifesaving treatment options.  Telestroke
can

 

efficiently treat patients in rural areas where
neurologists may not always be available. The

 

utilization of Telestroke has been shown to
increase the use of IV Tissue Plasminogen Activator

 

(tPA) which improves stroke outcomes such as better
quality of life, lower disability and

 

improved rehabilitation (McSweeney,
S., Pritt, J., Swearingern, A. & Coustasse, A.,2016). 

 

 

PROBLEM
STATEMENT

Many rural communities
lack adequate access to primary healthcare. 
According to the

Mississippi Department of Health, Mississippi ranked
close to last in ever health outcome

(Mississippi State Department of Health, 2016).  The American Stroke Association reported

Strokes were the number 5 killer in Mississippi in
2015.  Over 1,734 people died of a stroke
in

2015 (America Heart Association, 2015). Rural areas in
Mississippi have slimmer access to

quality health care. 
Even more, there are very few Neurologists across the state of
Mississippi to

treat these patients.  In the United States,
about 40 neurologists are available per 100,000

persons. Acute ischemic stroke is often misdiagnosed
by primary care or emergency medicine

physicians in up to 30 percent of cases (McSweeney, Swearing, Kimble, and
Coustasse,2017).

Telemedicine has been slow to roll out in rural
hospitals. A major problem across the state of

Mississippi is inadequate health care in the rural
areas. 

 

PURPOSE
STATEMENT

The purpose of this
qualitative action research study is to compare the outcomes of stroke

patients in the rural areas to inner city patients as
well as how socioeconomic status influence the

patient’s outcome and overall quality of life.  Treatment for stroke is very time
sensitive. 

Mississippi is vastly rural and several of the rural
hospitals have closed.  In most cases,
the

nearest hospital is 35 miles or more away putting
rural patient at risk.  Treatment within
3 hours

can mitigate the severity of the stroke. Telemedicine
for stroke can help to reduce time to

treatment and reduce the effect of the shortage of
neurologists in rural underserved areas.

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