Grant: CIHR New Investigator

Stroke is a common and debilitating medical problem, and a frequent cause of disability and death. Unlike many other medical conditions where the diagnosis and treatment decisions are based largely on laboratory or other diagnostic tests, diagnosis and treatment of stroke are strongly influenced by the symptoms patients describe. Therefore, the ability to communicate effectively with health care providers may influence stroke care. As Canada's population evolves, the proportion of the population that does not speak English or French continues to increase. Any disparities in stroke care due to language proficiency will have an increasing impact at a population level. The objective of this study is to compare the quality of care and clinical outcomes for Ontario stroke patients who are proficient in English and those who are not. We will use the Registry of the Canadian Stroke Network, which was established in 2001 to collect data about stroke care for people across Canada. The database includes detailed clinical information not available from other data sources, including language preferences. We will use these data to examine associations between language and stroke care and long-term outcomes. There is very little previous research studying stroke diagnosis and treatment for people with language barriers, even though stroke care is probably much more affected by communication than other diseases. Most of the previous studies on the impact of language on health care took place in the United States, where the language mixture is very different than in Canada, so the results of those studies are probably not applicable here. The results of this study will lead to greater understanding of the impact of communication and language on health care, which will lead to further research in this important area.