Beyond certification: why expanding medical services isn’t helping everyone equally
Shet et al.(1) analyze how the proliferation of Certified Stroke Centres for stroke treatment at various levels has had an unequal impact on American communities according to their socioeconomic status.
The study implements a population grouping system into three categories (Advantaged, Disadvantaged and Mixed) using the Area Deprivation Index (ADI) to assess socioeconomic well-being adapted to the ZIP code level.
Talking of the results of the article, we highlight:
- A reduction in the disparity in access to Acute Stroke Ready Hospitals between groups is observed over time. But this gap increases for Thrombectomy – Capable Stroke Centers and Comprehensive Stroke Center Hospitals up to 45 p.p, showing that the expansion of services has grown unevenly across the national territory.
- In 1 year mortality, the advantage group decreased 0.6 pp. On the other hand, no statistically significant improvement in the disadvantage group.
The distribution of benefits associated with the broader general certification of most hospitals has been directed toward groups with higher socioeconomic status. The authors suggest the necessity of strategic planning to increase guaranteed geographic accessibility to all population groups.
References:
1.- Shen, Y. C., Kim, A. S., & Hsia, R. Y. (2026). Does exposure to certified stroke centers affect all communities equitably? Stroke patient outcomes by community socioeconomic status. Annals of Emergency Medicine, 87(2), 143–156. https://doi.org/10.1016/j.annemergmed.2025.05.015
Author(s): David Ramirez Moro, The Biomedical Research Institute of Malaga and the Nanomedicine Platform