Introduction: Socioeconomic factors associated with regions play a significant role in their access to health care after discharge.

Objectives: We sought to determine the effect of socioeconomic variables on their outcomes at 3 months as determined by the modified Rankin scale (mRS).

Methods: A retrospective case control study was conducted from Jan 1, 2014 to May 31, 2016. Patients admitted to Buffalo General Hospital (BGH) and discharged to home were followed at 3 months for mRS. Independent t tests or Chi Square test were used along with Logistic regression to identify variables associated with outcome (mRS ≥ 3) at 3 months. 
Results: At 3 months 210 of the 1357 patients followed had poor outcomes while 1147 had favorable outcomes. Significant demographic predictors included age (Odds Ratio [OR] 1.04 per year, p < 0.001), black race (OR 1.72, p = 0.006), female (OR 1.62, p = 0.002) and discharge mRS (OR 5.05, p < 0.001). Socioeconomic predictors included distance from BGH (OR 0.99 per mile, p = 0.02) and educational attainment (percent high school graduates in ZIP code; OR 0.97 per 1% increase, p = 0.004). When socioeconomic variables were normalized for other variables, educational attainment remained a significant predictor of outcome (OR 0.97 per 1% increase, p = 0.02). 
Conclusions: Educational attainment of the region was associated with a decreased risk of a poor stroke outcome at 3 months. We suggest that patients from these regions have better access to health care compared to those patient regions with lower educational attainment.

ZIP Code of Residence is Related to Stroke Outcome at Three Months