Stroke Hospitalization in the Elderly with Medicare FFS

老年人中风住院医疗保险 FFS

基本信息

批准号：
7174187
负责人：
JUDITH H LICHTMAN
金额：
$ 25.09万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-02-15 至 2009-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7174187
关键词：
Address Admission activity Age Aged, 80 and over American Heart Association Blood Vessels Cardiovascular Diseases Cardiovascular system Caring Centers for Disease Control and Prevention (U.S.)Cerebrovascular Disorders Cessation of life Characteristics Clinical Clinical Research Cohort Studies Communities Comorbidity Congresses Coronary heart disease Cost of Illness Country Data Data Set Databases Diagnosis Disease Economics Elderly Enrollment Ethnic Origin Evaluation Fee-for-Service Plans Future Gender Geographic Locations Geography Goals Health Health Planning Healthcare Healthy People 2000 Healthy People 2010 Heart Diseases Hospital Mortality Hospitalization Hospitals Incidence Institution Intervention Investigation Ischemic Stroke Knowledge Life Link Measures Medical Surveillance Medicare Medicare Part A Minority Morbidity - disease rate Numbers Outcome Patient Care Patients Pattern Patterns of Care Physicians Policy Maker Population Prevention Principal Investigator Public Health Public Policy Race Rate Reporting Research Personnel Research Priority Resources Rural Science Source Staging Stroke Subgroup System Thinking Time United States United States Centers for Medicare and Medicaid Services United States Dept. of Health and Human Services United States National Institutes of Health Variant Vascular Diseases Work age difference age group base beneficiary brass cardiovascular disorder prevention cohort concept day demographics falls insight interest middle age mortality national surveillance prevent programs racial and ethnic racial difference size socioeconomics symposium trend

项目摘要

DESCRIPTION (provided by applicant): This country lacks a cohesive, informative surveillance system for vascular disease that can provide insights into national patterns of cerebrovascular disease and reveal national trends over time. Our overall goal is to build a surveillance system for the majority of patients admitted to the hospital with stroke in the United States, patients age > 65 years who are enrolled in the Medicare fee-for-service (FFS) option. We have assembled an unprecedented national resource by creating a longitudinal Medicare database for patients hospitalized with vascular diagnoses over the years 1992-1999, with ability to add years (through 2003 as part of this project). Since our original submission, our team has overcome considerable technical difficulties to create this database. This work has entailed transforming more than 5,000 data tapes into a viable data resource containing more than a terabyte of data. Previous studies using Medicare databases have employed a cross-sectional approach, not linking, at the patient level, the entire Medicare Part A (hospital admissions) database over time. No other organization or institution, not even the Centers for Medicare & Medicaid Services (CMS), has developed such a database. Our objective is to provide the most comprehensive evaluation of stroke and short-term mortality outcomes among hospitalized Medicare FFS beneficiaries in the United States. The evaluation will encompass the entire United States and span more than a decade. Accordingly, we propose the following specific aims: 1. To determine rates of stroke hospitalizations among Medicare beneficiaries in the United States. 2. To determine rates of hospital and 30-day mortality following stroke hospitalization among Medicare beneficiaries in the United States. 3. To determine patterns of stroke hospitalization among subgroups including by age, race and ethnicity, and by economic, political, and geographic characteristics. 4. To measure trends in stroke hospitalization rates over time Our work will help better define the burden of stroke among the elderly, inform policy-makers and clinicians in planning for the health care needs of stroke patients, and help identify targets for interventions to enhance the care of patients with stroke.

描述（由申请人提供）：这个国家缺乏针对血管疾病的凝聚力，信息丰富的监测系统，可以提供对脑血管疾病的民族模式的见解，并揭示了随着时间的推移的国家趋势。我们的总体目标是为美国中风送往医院的大多数患者建立一个监视系统，> 65岁的患者已入学，他们参加了医疗保险费用服务（FFS）。我们通过为在1992 - 1999年期间为住院的血管诊断的患者创建了一个纵向医疗保险数据库，组装了前所未有的国家资源，并具有增加数年的能力（直到2003年作为该项目的一部分）。自我们最初提交以来，我们的团队已经克服了创建此数据库的大量技术困难。这项工作需要将5,000多个数据磁带转换为一个可行的数据资源，该数据资源包含超过数据的数据。先前使用Medicare数据库的研究已采用横截面方法，而不是在患者级别上链接整个Medicare A部分（医院入院）数据库。没有其他组织或机构，甚至没有医疗保险和医疗补助服务中心（CMS）开发了这样的数据库。我们的目标是在美国住院的医疗保险FFS受益人中对中风和短期死亡率的最全面评估。评估将涵盖整个美国，并跨越十多年。因此，我们提出了以下具体目的：1。确定美国医疗保险受益人中卒中住院的比率。 2。确定美国医疗保险受益人中风住院后的医院和30天死亡率。 3。确定子群体中风住院的模式，包括年龄，种族和种族，以及经济，政治和地理特征。 4。为了衡量随着时间的推移，我们的工作将有助于更好地定义老年人的中风负担，告知决策者和临床医生，以计划中风患者的医疗保健需求，并帮助识别出干预措施的目标，以增强中风患者的护理。