cqvip:Background and Purpose:There is evidence of unequal access to health care int erventions even where universal health systems operate. We investigated associat ions between patients’sociodemographic characteristics and the provision of acu te and longer-term stroke care in a multiethnic urban population.Methods:We us ed data from 1635 patients with first-ever stroke, collected by a population-b ased stroke register from 1995 to 2000. Using multivariable analyses, controlled for sociodemographic and clinical factors, we investigated access to 22 evidenc e-based components of care. Results:1392 patients(85.1%) were admitted to hos pital; of these, 354 (25.4%) were admitted or transferred to a stroke unit. Of those with clinical need, 607 (70.7%) received physical therapies; 477 (59.8%) received speech and language therapy. Older age was associated with lower odds of hospitalization (odds ratio [OR], 0.50; 95%CI, 0.32 to 0.77, P=0.02) and dia gnostic brain imaging (OR,0.15; 95%CI, 0.08 to 0.30, P < 0.01) but higher odds of receiving physical therapy (OR, 4.24;95%CI, 1.22 to 14.73,P < 0.01).Black et hnicity was associated with higher odds of stroke unit admission (OR, 1.59; 95% CI, 1.01 to 2.49, P < 0.04). There was a weak association between socioeconomic status and admission to hospital and stroke unit. Gender was associated only wit h treatment of hypertension before stroke. Conclusions:Provision of individual components of care over 1 year varied for specific sociodemographic categories, but there was no consistent pattern of in equality. Clinical decision-making pr ocesses are likely to influence these patterns. Further information about clinic ian and patient roles in decision making is required.
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