Grant: Travel Awards - Institute Community Support

Integrated stroke systems have been implemented across Canada and include resources and services across the continuum, such as Stroke Prevention Services (SPS) which provide care to high-risk patients. Recent evidence reports the positive effects of SPS, however access to these services remains limited by location and comprehensiveness of the SPS, and access issues such as timely patient travel, the potential of which is unknown. This study aims to identify the proportion of the Canadian population, by province, with varying geographic access to stroke prevention services. A 2016 resource inventory administered by the Heart and Stroke Foundation identified 117 SPS across Canada, along with associated site-specific resources and practice information. These 117 sites were mapped using ArcGIS 10.3.1 (ESRI, 2015), and access to these sites was identified by catchment areas, based on interval driving times and distances from a neighbourhood to the closest SPS. The 2011 Census of Canada data was used to identify, at the finest geographic aggregation available, the population that lives within each driving interval catchment area. Analysis showed that 89.9% of the Canadian population lives within a 1 hour drive of a SPS. This proportion was similar for most provinces, however ON has a much greater proportion within a 1 hour drive (98.0%). Provinces with a significantly lower proportion of population <1 hour drive are SK (70.0%), NFL (53.7%), and NB (39.3%). Maps were generated based on this data to visualize the differences in geographic access between provinces. Additional work mapped and evaluated the extent to which geographic access is affected when site-specific factors are considered such as hours of operation, diagnostic services, and access to specialists. These maps are useful to aid in identifying disparities in access to SPS, and potential areas of need that may be valuable for stroke prevention service delivery and resource allocation planning.