Abstract
Background
We examine recent trends in U.S. emergency department (ED) and hospital care for stroke
and transient ischemic attack (TIA).
Method
We used national ED and inpatient data from the Healthcare Cost and Utilization Project
2006–14. We explored trends in care and outcomes for patients treated in U.S. hospitals
with stroke and TIA using descriptive statistics, as well as intracranial hemorrhage
(ICH), a complication of stroke treatment.
Results
From 2006 to 14, there were 3.9 million U.S. ED visits with stroke and 2.5 million
with TIA. Over the study, stroke visits grew 25% while TIA decreased 2%. Both conditions
were more common among women and older adults, and most had Medicare insurance; however,
Medicaid increased from 5.8% to 9.6% for stroke and 4.3% to 7.5% for TIA. Full inpatient
hospitalizations fell for stroke from 89% to 83%, and TIA from 61% to 47%. Transfers
from the ED for stroke & TIA increased from 4% to 8% and 2% to 5%, respectively. Inpatient
mortality decreased for stroke & ICH and costs increased for all three conditions;
however, length of stay (LOS) did not significantly change.
Conclusion
Over this nine-year study period, the average age of stroke & TIA patients was unchanged
in U.S. hospitals; however, the proportion with Medicaid insurance increased considerably.
Stroke incidence increased while TIA decreased slightly. Full inpatient hospitalizations
are declining for both conditions, while transfers are on the rise. Average inpatient
costs increased dramatically for all three conditions while mortality for stroke &
ICH fell significantly.
Keywords
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Article Info
Publication History
Published online: August 08, 2018
Accepted:
August 7,
2018
Received in revised form:
July 28,
2018
Received:
May 7,
2018
Footnotes
☆All authors have read and approved the submitted manuscript, the manuscript has not been submitted elsewhere nor published elsewhere in whole or in part.
☆☆There are no identified conflicts of interest or grant funding to this study.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
