Abstract TP148: The Need for Standardized Stroke Care: Assessing Global Provider Training and Institutional Disparities

Abstract

The development of vascular neurology as the primary specialty for stroke evaluation and treatment is a relatively recent advancement. Vascular neurology is well-established in the United States, ensuring most stroke patients receive specialized care, but many stroke patients globally are managed by physicians without specialized training in cerebrovascular and neurological medicine that is partly manifested by the availability of institutions that incorporate dedicated stroke training. Our goal is to evaluate the training of stroke providers worldwide to identify who is leading stroke care in different regions, and to assess the availability of dedicated stroke education within these regions. This evaluation aims to highlight disparities and ultimately work towards the global standardization of stroke care. We distributed an international survey to assess level of training of physicians treating stroke, if dedicated stroke training (e.g., fellowships) is available at their institution and location where they practice. Preliminary results from our ongoing survey show the average age of 83 respondents was 38.29 ± 7.72 and no difference in proportion of males (n=44) and females (n=39, p=0.0025). Physicians who treat the hyperacute phase of stroke indicated their level of training (Vascular Neurologist n=19, Other n=40, p=0.0045) (Figure 1). A subset analysis of non-vascular neurologists revealed that most ‘Other’ physicians worked in areas where no vascular neurology training was available (vascular neurology training available n=11, not available n=24, p=0.0410) (Figure 2). Distribution of vascular neurologist’s vs other physicians treating stroke indicate countries where there is increased proportion (i.e UK, Switzerland, Czech Republic, Argentina, USA) and decreased proportion of dedicated vascular neurology training (Honduras, Colombia, Nepal, Kenya, Papua New Guinea, Tanzania, Bolivia, Hungary) (Figure 3). While the availability of vascular neurology is growing internationally, our preliminary results from this ongoing survey indicate there is still a disparity amongst currently practicing physicians who are taking care of acute and subacute patients. Accordingly, this disparity in training may affect patient outcomes; hence, these preliminary data serve to bolster stroke care internationally by identifying areas of training and institutional disparity, all with the goal of improving outcomes in stroke patients through global standardization of care.