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Description of problem In 2016 the Centers for Disease Control and Prevention CDC in 2016 stroke was the fifth leading cause of death in the United States US Stroke is a leading cause of long term disability in adults Approximately 795 000 people in the U S suffer from a stroke each year Roger et al 2012 In 2017 the estimated cost of stroke care including health care services pharmacological therapy and days missed from work totaled over 34 billion CDC gov stroke When treatment is received within the first few hours of a stroke research has demonstrated that patients have a 30 reduction in disability and mortality According to the 2016 Rural Health Information Hub 53 9 of Mississippians reside in a rural area most without adequate access to a neurologist trained in acute stroke care In 2017 a national study comparing emergency medicine service EMS response times in rural versus urban areas found that rural areas experienced significantly slower EMS times Rural area response times were found to be more than double the time noted in urban areas at 26 minutes and 14 minutes respectively Additionally 22 of people in the rural U S are within a 30 minute drive to a facility staffed with a neurologist Albright et al 2010 When studying the time it takes EMS to respond to a rural location in conjunction with the time spent transporting the patient to a facility equipped to treat stroke on average one hour has already elapsed NEJM
