Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Annie N. Simpson

Second Advisor

Jillian B. Harvey

Third Advisor

Mark Persin

Fourth Advisor

James S Zoller


Stroke is a disease that is responsible for disabling more of its victims that any other disease in the United States. There are four types of stroke. However, ischemic stroke is responsible for 87% of all strokes. T-PA is a pharmaceutical that has proven an effective treatment for ischemic stroke patients since 1996. T-PA works by dissolving the thrombosis that has become lodged in a brain vessel. This pharmaceutical has its limitations; mainly it must be administered within 4.5 hours of symptom onset. Nationally, the medical field experiences low utilization rates, between 3-5%. The many variables that affect this low usage rate, however, this study focuses on patient’s residence in a county that offers telestroke services compared to counties that do not have telestroke services. In completion, of the necessary research, archival data from the 2013 Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for South Carolina was utilized. Hospital encounters that had a primary diagnosis code of 424.xx & 436.xx (ICD- 9-CM) were identified for analysis. The analysis revealed 9,311 South Carolinians suffered a stroke in 2013 while a total of 461 patients were administered t-PA (4.95%). The study found a greater percentage of patients living in “Telestroke Access” counties received t-PA compared to those that did not, 5.11% to 4.76%, respectively. However, the county in which patients resides was not a statistically significant indicator because of the p-value = 0.36.


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