Investigation of Disparities in Geographic Accessibility to Emergency Stroke and Myocardial Infarction Care in East Tennessee Using Geographic Information Systems and Network Analysis

PurposeStroke and myocardial infarction (MI) require timely geographic accessibility to emergency care. Historically, studies used straight line distances as measures of geographic accessibility. Recently, travel time has been recognized as a better indicator of accessibility because travel impedances can be considered. This study used finer grained transportation data and network analysis to investigate neighborhood disparities in travel time to emergency stroke and MI care.MethodsTravel times to stroke and cardiac centers were computed using network analysis, while considering distance, speed limit, road connectivity, and turn impedances. Neighborhoods within 30, 60, or 90 minutes travel were identified. Travel time by air ambulance was calculated and adjusted for flying speed and some delays.ResultsApproximately 8% and 15% of the study population did not have timely geographic accessibility to emergency stroke and MI care, respectively. Populations with poor access were located in rural areas. The entire study population had timely access by air ambulance.ConclusionsThis study identified disparities in geographic accessibility to emergency stroke and MI care in East Tennessee. Use of air ambulance or telemedicine could play a vital role in addressing these disparities. This information is important for evidence-based health planning and resource allocation.