Do women receive equivalent stroke care to men?

New research presented by George Dunn, Project Manager of the Sentinel Stroke National Audit Programme, at the European Stroke Organisation Conference 2018 suggests not.

George and his colleagues from the School of Population Health & Environmental Sciences, looked at 83,484 patient records that were admitted from April 1st 2016 – 31st March 2017 across England, Wales and Northern Ireland. They used eleven pre-determined quality measures of acute stroke care and adjusted their analysis for a range of other potential factors such as age, stroke type, diabetes, hypertension and time from onset to admission.

Of the eleven quality measures tested none favoured female patients whereas six were most likely to be achieved in the care of males. Women are in particular less likely to receive thrombolysis quickly or to receive a physiotherapy assessment within 72 hours of admission.

Although the study only focussed on acute care and did not include measures of longer term care, rehabilitation or patient outcomes these results show that female patients with stroke were not as well looked after in the critical early stages. The authors are not clear why care quality is different for men and women or why there are differences for some quality metrics but not others. Further investigation is required to better understand these apparent inequalities and so take steps to combat them.  

George, whose presentation won the Paola De Rango Award for high quality research on stroke in women, said of the study:

‘Using data from the Sentinel Stroke National Audit Programme (SSNAP), we discovered for six out of eleven quality measures of acute stroke care that men receive favourable care to women. More research needs to be done in order to ensure these results are consistent. We do not yet know whether this has any direct impact on patient outcomes, but it is certainly an area for further study. It may also be valuable to analyse whether the favouring of men in these aspects of acute care is uniform across the country, or whether there are certain areas which have a greater problem.’