Impact of regional differences in stroke symptom awareness and low-income status on seeking emergency medical service in China

作     者：Jing Yuan Guang-Liang Shan Sheng-De Li Chun-Peng Gao Li-Ying Cui Bin Peng Yuan Jing;Shan Guang-Liang;Li Sheng-De;Gao Chun-Peng;Cui Li-Ying;Peng Bin;on behalf of the FAST-RIGHT Investigators and Coordinators

作者机构：Department of NeurologyPeking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Epidemiology and StatisticsInstitute of Basic Medical SciencesChinese Academy of Medical SciencesSchool of Basic MedicinePeking Union Medical CollegeBeijingChina Disease Control and Prevention OfficeDalian Municipal Central HospitalDalianLiaoning 116021China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2021年第134卷第15期

页      面：1812-1818页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

基　　金：grants from the Ministry of Finance of the People’s Republic of China(Issued by Finance and Social SecurityDocument No.50,Ministry of Finance) the Ministry of Science and Technology of the People’s Republic of China(No.2016YFC0901004). 

主　　题：Stroke Cerebrovascular disease Awareness Income Emergency medical service Developing countries 

摘      要：Background:Unawareness of stroke symptoms and low income are two barriers that affect the seeking of emergency medical service(EMS).This study aimed to assess the effect of unawareness and low income on seeking EMS and to investigate the regional distribution of the unawareness and low-income status and their associations with failing to call EMS in China.Methods:A total of 187,723 samples from the China National Stroke Screening Survey was interviewed cross-sectionally.Four status of awareness and annual income were identified:unaware and low-income,unaware-only,low-income-only,and aware and regular income.The outcomes were whether they intended to call EMS or not.The regional distribution of each status and their associations with not calling EMS were presented.Results:The status of unaware and low-income,unaware-only,and low-income-only accounted for 6.3%(11,806/187,673),11.9%(22,241/187,673),and 21.5%(40,289/187,673)of the total sample,respectively.Not calling EMS was significantly associated with the status of unaware and low-income(odds ratio[OR]:3.21,95%confidence interval[Cl]:3.07-3.35),unaware-only(OR:2.38,95%Cl:2.31-2.46),and low-income-only(OR:1.67,95%Cl:1.63-1.71),compared with the aware and regular income status.The Midwest regions had higher percentages of people in the unaware and low-income status;the East,South,and Central had higher percentages of unaware-only status;the North and Northeast regions had a higher percentage of low-income-only status,compared with other regions.Conclusion:The existence of the regional difference in unawareness and low income justifies the specific stroke education strategies for the targeted regions and population.