Abstract A099: Geospatial Analysis to Determine Optimal Distribution of Mobile Stroke Units

Background: Mobile Stroke Units (MSUs) can significantly improve the outcomes of stroke treatment by enabling faster intravenous thrombolysis. However, they are costly and the optimal deployment strategies remain unclear, particularly for rural and underserved populations. Objective: To use geospatial analysis to determine the optimal geographic distribution of MSUs in Texas, with the aim of maximizing coverage of stroke patients and targeting rural, socially vulnerable and minority populations. Methods: We conducted a statewide geospatial analysis in Texas using publicly available data, including CDC PLACES, Social Vulnerability Index, Rural-Urban Commuting Area (codes, and the Texas Department of State Health Services stroke facility database. Level-I and II stroke centers were geocoded, and drive-time buffers (30, 60, 120, and 180 minutes) around these centers were modeled using ArcGIS Pro. MSU rendezvous points with Emergency Medical Services (EMS) units were assumed to be located halfway between rural stroke locations and stroke centers. Coverage was compared against a baseline 30-minute EMS transport to all stroke centers. Results: We identified fourteen optimal MSU locations (11 Level I and 3 Level II centers) in Texas. Using an 180-minute drive time radius (with a 90-minute rendezvous time), it was estimated that approximately 741,852 stroke patients (99.1% of all stroke patients in Texas) could receive treatment within three hours. This represented a 16.6% increase compared to the baseline EMS scenario. Notably, coverage for rural stroke patients increased by 279%. Using a 120-minute buffer increased treatment availability by 12.3% overall, and by 232% for rural patients. While the 60-minute buffer showed no net increase in patients treated, it enabled 600,101 individuals already covered by EMS to receive care more quickly. Conclusions: Geospatial modelling shows that the strategic deployment of mobile stroke units (MSUs) could greatly improve stroke treatment accessibility and outcomes across Texas, particularly for rural and underserved populations. These findings provide health policymakers with a scalable approach to optimizing MSU placement and reducing disparities in stroke care delivery.