Healthcare Utilization for Stroke Patients at the End of Life: Nationally Representative Data

2021 ◽  
Vol 30 (10) ◽  
pp. 106008
Author(s):  
Sarah A. Levy ◽  
Elizabeth Pedowitz ◽  
Laura K. Stein ◽  
Mandip S. Dhamoon
Keyword(s):  
End Of Life ◽  
Healthcare Utilization ◽  
Stroke Patients ◽  
Representative Data ◽  
Nationally Representative

Pregnancy and Neonatal Outcomes Among Deaf or Hard of Hearing Women: Results From Nationally Representative Data

2021 ◽  
Author(s):  
Monika Mitra ◽  
Michael M. McKee ◽  
Ilhom Akobirshoev ◽  
Grant A. Ritter ◽  
Anne M. Valentine
Keyword(s):  
Hard Of Hearing ◽  
Neonatal Outcomes ◽  
Representative Data ◽  
Nationally Representative

Abstract WP340: Prevalence and Influence of Chronic Obstructive Pulmonary Disease on Stroke Outcomes in Hospitalized Stroke Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Oladimeji Akinboro ◽  
Odunayo Olorunfemi ◽  
Stanley Holstein ◽  
Daniel Pomerantz ◽  
Stephen Jesmajian ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Stroke Patients ◽  
Obstructive Pulmonary Disease ◽  
Index Stroke ◽  
Nationally Representative ◽  
Shared Risk

Background: COPD recently overtook stroke as the third leading cause of death in the United States. Intriguingly, smoking is an important shared risk factor for both stroke and COPD; COPD patients have baseline cerebral hypoxia and hypercapnia that could potentially exacerbate vascular brain injury; and stroke patients with COPD are at higher risk of aspiration than those without COPD. Yet, relatively little is known about the prevalence of COPD among stroke patients or its impact on outcomes after an index stroke. Objective: To assess prevalence of COPD among hospitalized stroke patients in a nationally representative sample and examine the effect of COPD with risk of dying in the hospital after a stroke. Methods: Data were obtained for patients, 18 years and older, from the National Inpatient Sample from 2004-2009 (n=48,087,002). Primary discharge diagnoses of stroke were identified using ICD-9 diagnosis codes 430-432 and 433-436, of which a subset with comorbid COPD were defined with secondary ICD-9 diagnoses codes 490-492, 494, and 496. In-hospital mortality rates were calculated, and independent associations of COPD with in-hospital mortality following stroke were evaluated with logistic regression. All analysis were survey-weighted. Results: 11.71% (95% CI 11.48-11.94) of all adult patients hospitalized for stroke had COPD. The crude and age-adjusted in-hospital mortality rates for these patients were 6.33% (95% CI 6.14-6.53) and 5.99% (95% CI 4.05-7.94), respectively. COPD was independently and modestly associated with overall stroke mortality (OR 1.03, 95% CI 1.01-1.06; p=0.02). However, when analyzed by subtype, greater risks of mortality were seen in those with intracerebral hemorrhage (OR 1.12, 95% CI 1.03-1.20; p<0.01), and ischemic stroke (OR 1.08; 95% CI 1.03-1.13, p<0.01), but not subarachnoid hemorrhage (OR 0.98, 95% CI 0.85-1.13; p=0.78). There were no statistically significant interactions between COPD and age, gender, or race. Conclusion: 12% of hospitalized stroke patients have COPD. Presence of COPD is independently associated with higher odds of dying during ischemic stroke hospitalization. Prospective studies are needed to identify any modifiable risk factors contributing to this deleterious relationship.

Abstract P253: Readmission in Acute Ischemic Stroke Patients Undergoing Endovascular Treatment

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Saqib Chaudhry ◽  
Ibrahim Laleka ◽  
Zelalem Bahiru ◽  
Hassan S Gill ◽  
Mohammad Rauf Chaudhry ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Intracranial Hemorrhage ◽  
Stroke Patients ◽  
Factors Associated ◽  
Representative Study ◽  
Post Procedure ◽  
Icd 10 ◽  
Nationally Representative

Background: Recent trials have demonstrated a reduction in death or disability with endovascular treatment in patients with acute ischemic strokes. However, readmission rates and predictors are not known. Objective: To identify rates and factors associated with 30-day readmission after endovascular treatment in ischemic stroke patients. Methods: Nationwide Readmissions Data (NRD) between 2010 and 2017 was utilized to identify endovascular treatment in acute ischemic stroke patients using ICD-9 and ICD-10 codes. We used hierarchical logistic regression model to identify factors associated with 30-day readmissions. Results: Among 17, 562 acute ischemic stroke patients who survived to discharge after endovascular treatment, 2334 (13.29%) were readmitted within 30-days. Age => 65 years (odds ratio [OR]: 1.23, 95% confidence interval [CI]: 1.09 to 1.39, p =0.0005), chronic kidney disease (OR: 1.28, 95%CI: 1.12 to 1.47, p = 0.0004), congestive heart failure (OR: 1.25, 95%CI: 1.13 to 1.39, p <.0001), post procedure intracranial hemorrhage (OR: 1.09, 95%CI: 0.99 to 1.20, p = 0.04) and diabetes mellitus (OR: 1.09, 95%CI: 0.99 to 1.20, p = .09) during the index hospitalization were associated with readmission within 30 days. Conclusion: In this large nationally representative study, nearly one in 10 patients were readmitted within 30 days after discharge in acute ischemic stroke patients undergoing endovascular treatment. Medical comorbidities and post procedure intracranial hemorrhage were associated with 30-day readmission.

Influence of Income on Health Status and Healthcare Utilization in Working Adults: an Illustration of Health among the Working Poor in Japan

2009 ◽  
Vol 10 (1) ◽  
pp. 79-92 ◽  
Author(s):  
YASUHARU TOKUDA ◽  
SACHIKO OHDE ◽  
OSAMU TAKAHASHI ◽  
SHIGEAKI HINOHARA ◽  
TSUGUYA FUKUI ◽  
...  
Keyword(s):  
Health Status ◽  
Healthcare Utilization ◽  
Income Group ◽  
Working Poor ◽  
Linear Regression Models ◽  
Working Adults ◽  
Co Morbidity ◽  
Representative Random Sample ◽  
Nationally Representative ◽  
The Government

AbstractLittle is known about health of the growing subpopulation of the working poor in Japan. We aimed to evaluate health status and healthcare utilization in relation to income among Japanese working adults. We conducted a one-month prospective cohort study using a health diary in working adults from a nationally representative random sample in Japan. Based on the government criterion, the working poor group was defined as earning an equivalent annual income of less than 1.48 million Japanese-yen. For health status, we measured symptomatic episodes and health-related quality of life (HRQOL). For healthcare utilization, we measured frequencies of visits to a physician or pharmacy, and use of complementary and alternative medicine (CAM). We constructed multiple linear regression models for these measures adjusted for age, gender, and co-morbidity, using annual equivalent income as a 4-level categorical variable.Of 3,568 participants originally enrolled in the study panel, 3,477 completed the survey (response rate 97%). For the purpose of the study, of the 3,568 participants, we analyzed 1,406 working adults who were 20–65 years old (mean age, 40.8 yr: 58.4% men). There were 106 (7.5%) working poor: 56 men (6.8% of working men) and 50 women (8.5% of working women). Compared to the highest income group, the working poor reported the greater number of symptomatic episodes and a slightly lower score of physical component of HRQOL (PCS8). The numbers of symptomatic episodes among the working poor and the highest income group during the 1-month study period were 9.79 (SD, 8.77) and 7.01 (SD, 7.34), respectively (p < 0.01). The PCS8 among the working poor was 48.71 (SD, 7.05) and it was 50.34 (SD, 6.55) among the highest income group (p < 0.01). There was no difference of healthcare utilization by the different levels of income.We concluded that the working poor (7.5% of all working adults) more frequently report symptomatic episodes and show slightly poorer physical health status, compared to the highest income group. Healthcare utilization is not affected by income.

The impact of investment on drinking water quality in rural China

2017 ◽  
Vol 9 (2) ◽  
pp. 255-269
Author(s):  
Ai Yue ◽  
Yaojiang Shi ◽  
Renfu Luo ◽  
Linxiu Zhang ◽  
Natalie Johnson ◽  
...  
Keyword(s):  
Water Quality ◽  
Drinking Water ◽  
Rural Areas ◽  
Tap Water ◽  
Rural China ◽  
Ordinary Least Squares ◽  
Content Type ◽  
Representative Data ◽  
Nationally Representative ◽  
The Impact

Purpose Although access to safe drinking water is one of the most important health-related infrastructure programs in the world, drinking water remains a large problem in China today, especially in rural areas. Despite increased government investment in water resource protection and management, there is still an absence of academic studies that are able to document what path the investment has taken and whether it has had any tangible impact. The purpose of this paper is to analyze the impact of drinking water investment on drinking water in China. Design/methodology/approach The authors make use of nationally representative data from 2005 and 2012 to measure the impact of drinking water investment among 2,028 rural households in 101 villages across five provinces. Both ordinary least squares regression and probit regression are used to analyze the correlates and the impact of drinking water investment. Findings The authors demonstrate that water quality was likely a significant problem in 2004 but that China’s investment into drinking water appears to have resulted in initial improvements during the study period. The authors show that the most significant change came about in terms of hardware: villages that received more drinking water investment now have more piped tap water and more access to water treatment infrastructure (disinfecting and filtering facilities). High rates of rural resident satisfaction with drinking water suggest the effects of drinking water investment are being felt at the village level. Originality/value To the authors’ knowledge, this is the first empirical study on drinking water investment over time in rural China using nationally representative data.

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