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Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects.

Publication ,  Journal Article
Roth, DL; Sheehan, OC; Huang, J; Rhodes, JD; Judd, SE; Kilgore, M; Kissela, B; Bettger, JP; Haley, WE
Published in: Int J Stroke
October 2016

Background Differences in healthcare utilization after stroke may partly explain race or gender differences in stroke outcomes and identify factors that might reduce post-acute stroke care costs. Aim To examine systematic differences in Medicare claims for healthcare utilization after hospitalization for ischemic stroke in a US population-based sample. Methods Claims were examined over a six-month period after hospitalization for 279 ischemic stroke survivors 65 years or older from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Statistical analyses examined differences in post-acute healthcare utilization, adjusted for pre-stroke utilization, as a function of race (African-American vs. White), gender, age, stroke belt residence, income, Medicaid dual-eligibility, Charlson comorbidity index, and whether the person lived with an available caregiver. Results After adjusting for covariates, women were more likely than men to receive home health care and to use emergency department services during the post-acute care period. These effects were maintained even after further adjustment for acute stroke severity. African-Americans had more home health care visits than Whites among patients who received some home health care. Having a co-residing caregiver was associated with reduced acute hospitalization length of stay and fewer post-acute emergency department and primary care physician visits. Conclusions Underutilization of healthcare after stroke does not appear to explain poorer long-term stroke outcomes for women and African-Americans in this epidemiologically-derived sample. Caregiver availability may contribute to reduced formal care and cost during the post-acute period.

Duke Scholars

Published In

Int J Stroke

DOI

EISSN

1747-4949

Publication Date

October 2016

Volume

11

Issue

8

Start / End Page

928 / 934

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Sex Factors
  • Racial Groups
  • Patient Acceptance of Health Care
  • Neurology & Neurosurgery
  • Medicare
  • Male
  • Length of Stay
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Roth, D. L., Sheehan, O. C., Huang, J., Rhodes, J. D., Judd, S. E., Kilgore, M., … Haley, W. E. (2016). Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects. Int J Stroke, 11(8), 928–934. https://doi.org/10.1177/1747493016660095
Roth, David L., Orla C. Sheehan, Jin Huang, James D. Rhodes, Suzanne E. Judd, Meredith Kilgore, Brett Kissela, Janet Prvu Bettger, and William E. Haley. “Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects.Int J Stroke 11, no. 8 (October 2016): 928–34. https://doi.org/10.1177/1747493016660095.
Roth DL, Sheehan OC, Huang J, Rhodes JD, Judd SE, Kilgore M, et al. Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects. Int J Stroke. 2016 Oct;11(8):928–34.
Roth, David L., et al. “Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects.Int J Stroke, vol. 11, no. 8, Oct. 2016, pp. 928–34. Pubmed, doi:10.1177/1747493016660095.
Roth DL, Sheehan OC, Huang J, Rhodes JD, Judd SE, Kilgore M, Kissela B, Bettger JP, Haley WE. Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects. Int J Stroke. 2016 Oct;11(8):928–934.
Journal cover image

Published In

Int J Stroke

DOI

EISSN

1747-4949

Publication Date

October 2016

Volume

11

Issue

8

Start / End Page

928 / 934

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Sex Factors
  • Racial Groups
  • Patient Acceptance of Health Care
  • Neurology & Neurosurgery
  • Medicare
  • Male
  • Length of Stay
  • Humans