Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107521

William Buczko, PhD, ORDI/REG/DBR, Centers for Medicare & Medicaid Services, 7500 Security Blvd. C3-19-07, Baltimore, MD 21244-1850, (410) 786-6593, Wbuczko@cms.hhs.gov

This study examines the incidence of hospitalizations for stroke among elderly Medicare beneficiaries. Stroke in the Medicare population is a leading cause of death and is also a cause of physiologic, functional and psychological impairment that often results in institutionalization and functional decline. Stroke incidence and mortality increases with age. African-Americans have a markedly greater incidence of stroke and greater subsequent mortality. MEDPAR inpatient hospital discharge data are examined for Medicare fee-for-service beneficiaries age 65 or over discharged during fiscal year 1999 with a principal diagnosis of ICD-9-CM code 436.0 (N=79,734). Incidence patterns and length of stay are examined by age, race and sex. Source of admission, post-acute care use, in-hospital and post-discharge mortality are also examined. The average elderly Medicare beneficiary hospitalized for stroke was 80 years old. Nearly 62% of these patients were female. Approximately 84% of the patients were white and 12% were black. Over 71% of admissions came from the emergency room. The average length of stay for these hospitalizations was 5.2 days. The average inpatient charge was $9,621, which is markedly less than the average charge for all Medicare inpatient discharges ($15,373). Elderly Medicare stroke patients frequently required additional formal care after discharge. While 30.3% of stroke patients were discharged to home, 57.7% were discharged to some form of post-acute care. Approximately 8% of patients hospitalized for stroke died during hospitalization and approximately 34% of hospitalized patients died within one year after discharge. In-hospital and post-discharge mortality were greater among older age groups.

Learning Objectives:

• Recognize the factors associated with stroke incidence, mortality and inpatient resource use.

Keywords: Medicare, Strokes

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.