The Disease Ecology Of Stroke At A Large Tertiary Health Care Center In West Virginia

Background
The organization of people and health care resources is critical for efficiently and effectively managing a health care system. Studying healthcare delivery became more widespread as theories and technologies of optimizing healthcare delivery advanced (Pyle, 1983). Disease states such as (Stroke) are debilitating illnesses that can cause increased mortality.

Methods
We analyzed stroke deaths from 2008 – 2016 (n=1350) and utilized an optimized outlier analysis to assess if any clustering occurred in the service area of Charleston Area Medical Center or transfers to the network. Data points were obtained from the data warehouse located at CAMC and examined using Arch 10.6. The data was geocoded and then fit into the defined boundaries of the zip code level to explore any potential spatial trends further.

Results
Results suggest as shown in (Figure 1) that there are statistically significant zones (p=0.001) occurring within several areas. This pilot study illustrates that these zones to tend to be increased in areas of economic hardship and lower than average median household income. As a result, mortality tends to be clustering in these zones and poses a potential challenge to the implication of health in the region.

Conclusions
Health service delivery and access are essential to overall patient care. Understanding potential zones of health inequality are critical to improving health-related outcomes. Using stroke in the case of this study illustrates that shifting medical resources are needed to effect change in these specific at-risk zones shown in (Figure 1).