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APHA Scientific Session and Event Listing

William Buczko, PhD, CMS/ORDI, 7500 Security Blvd. C3-19-07, Baltimore, MD 21244, (410) 786-6593, wbuczko@cms.hhs.gov

Transient ischemic attack (TIA) is a comparatively mild form of stroke with low incidences of subsequent institutionalization and mortality. This study is concerned with determining if elderly Medicare beneficiaries newly hospitalized for TIA in FY 1999 are likely to be hospitalized for stroke in FY 2000. Also, are rehospitalized beneficiaries likely to be treated for a more severe form of stroke? The effects of rehospitalization on short and long term survival are also examined. MEDPAR inpatient hospital discharge data are examined for Medicare fee-for-service beneficiaries age 65 or over discharged during FY 1999 with a principal diagnosis of ICD-9-CM codes 435.0 – 435.9 and no prior stroke hospitalization in FY 1997 or FY 1998 (N=96,755). FY 2000 MEDPAR data were examined for hospitalizations for ICD-9-CM codes 430 – 436. Hospitalization patterns are examined by age, race and sex. In-hospital and post-discharge survival are also examined. Only 7% of the cohort of beneficiaries hospitalized for TIA in FY 1999 were subsequently hospitalized for any form of stroke during FY 2000 (n=6684). Older beneficiaries, blacks and Hispanics were more likely to be rehospitalized in FY 2000. Nearly 56% of those rehospitalized had a more severe form of stroke (i.e. hemorrhage, infarction, arterial occlusion, non-specific) while 44% were rehospitalized for TIA. Over 60% of rehospitalized blacks had a more severe second stroke. While little difference in short-term post discharge survival was noted, rehospitalized beneficiaries had increasingly lower survival rates from 2 to 5 years post-discharge.

Learning Objectives:

• The participant will be able to identify the extent to which TIA episodes result in later strokes in an elderly population.

Keywords: Strokes, Medicare

Presenting author's disclosure statement:

Not Answered

Handout (.pdf format, 68.3 kb)