# Addressing Racial/Ethnic Disparities in Stroke Care Access Using Hospital Transfer Networks

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $659,794

## Abstract

PROJECT SUMMARY
Stroke occurs commonly in older patients and is a leading cause of long-term disability. Disability and death
from stroke can be reduced with timely reperfusion interventions (i.e., intravenous thrombolysis and
endovascular thrombectomy) and high-quality stroke center care. Unfortunately, patients from minority or
underserved populations have less access to reperfusion interventions and acute stroke expertise. This is
largely because stroke centers – the hospitals best equipped to care for stroke patients – are not
geographically distributed to match where patients live and many patients initially present to smaller, non-
stroke center hospitals. Valuable work has been done to improve the capabilities of that first, smaller hospital,
for example through the expansion of telestroke. However, the most effective interventions for stroke will
require transfer. Endovascular thrombectomy is only available at hospitals with advanced capabilities, and
there are significant geographic and racial/ethnic disparities in access to this highly efficacious intervention.
An optimized system of interhospital stroke patient transfers could be a solution to more equitable access to
high-quality stroke care. While many factors contributing to disparities in access and outcomes are relatively
fixed (e.g., patient demographics or hospital locations), the process of interhospital patient transfers is dynamic
and subject to intervention. The decision to transfer, and the timeliness and destination of that transfer decision
can be influenced toward improved outcomes tomorrow. Yet there are many factors influencing patient transfer
decisions. In this mixed-methods study, we use statewide, all-payer claims data to study the network of over
340 California hospitals connected through stroke patient transfer to understand the relationship between
transfer decisions and disparities in patient access and outcomes. We will apply methods from network
science, which are ideally suited to characterize and study the dynamic, multi-level, interdependent structure of
the stroke patient transfer network. We will develop and apply new methods in network community detection to
identify clusters of hospitals closely connected through patient transfer and to study how the racial/ethnic
composition of hospital clusters is associated with stroke-related capabilities in the cluster and how clusters
change over time (Aim 1). We will quantify patient-level racial and ethnic disparities in stroke access and
outcomes and identify factors at the hospital cluster-level associated with disparities (Aim 2). Then, upon
identifying clusters of hospitals that are positive and negative deviants (as outliers in achieving high levels of
access and low disparities), we will use qualitative methods to identify scalable strategies to reduce inequalities
in stroke access and outcomes (Aim 3). We believe that that these solutions will be valuable to health system
leaders and policy makers aiming...

## Key facts

- **NIH application ID:** 10912031
- **Project number:** 5R01AG079887-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Korilyn Sauser Zachrison
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $659,794
- **Award type:** 5
- **Project period:** 2023-09-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10912031

## Citation

> US National Institutes of Health, RePORTER application 10912031, Addressing Racial/Ethnic Disparities in Stroke Care Access Using Hospital Transfer Networks (5R01AG079887-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10912031. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*