Despite a decade of progress in stroke care, Black patients continue to receive fewer life-saving treatments than White patients—even when treated at the same certified hospitals. A new study of over 2.1 million Medicare stroke admissions reveals that stroke center certification significantly boosted treatment rates for White patients, but not for Black patients.
When hospitals became certified as primary stroke centers, White patients saw a 31% increase in thrombolytic therapy. That number jumped to nearly 68% at more advanced centers. Black patients, however, saw no statistically significant change in access to thrombolytics, even at the same facilities.
Mechanical thrombectomy rates also rose sharply for White patients—by over 500%—after hospitals gained advanced certification. Black patients experienced a modest 137% increase, despite starting from a lower baseline. “These within-hospital differences…serve as sobering evidence that significant barriers persist,” the authors wrote.
The disparities weren’t explained by age, comorbidities, or hospital type. Instead, researchers pointed to systemic issues: Black patients are less likely to use emergency services, more likely to arrive late to the ER, and face longer wait times. They’re also more likely to refuse treatment.
Even as stroke centers expanded and patient volumes grew, the racial gap in treatment widened. The study concludes that broader insurance coverage alone isn’t enough. Targeted education and structural reforms are needed to ensure equitable stroke care.
See: “Stroke Center Certification and Within-Hospital Racial Disparities in Treatment” (July 30, 2025)
