Disparities in Patterns of Recurrent Stroke in the Elderly

老年人复发性中风模式的差异

基本信息

批准号：
9911542
负责人：
JUDITH H LICHTMAN
金额：
$ 23.45万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9911542
关键词：
Address Administrative Supplement Adult African American Aging Alaska Native American American Heart Association American Indians American Stroke Association Asian Americans Caring Carotid Endarterectomy Cause of Death Centers for Disease Control and Prevention (U.S.)Cessation of life Chronic Clinical Data Clinical Management Color Data Data Reporting Data Set Disabled Persons Disease Elderly Ethnic Origin Event Fee-for-Service Plans Female Future Geographic Locations Grant Growth Health Insurance Healthcare Healthcare Systems High Prevalence Hispanics Hospitalization Information Systems Institute of Medicine (U.S.)Investigation Knowledge Latino Left Low income Medicaid Medical Medicare Medicare/Medicaid Minority Groups National Institute of Neurological Disorders and Stroke National Institute on Aging Native Hawaiian Outcome Pacific Island Americans Parents Patient-Focused Outcomes Pattern Persons Population Populations at Risk Procedures Proxy Public Health Public Policy Race Recurrence Research Research Personnel Research Priority Resources Risk Services Societies Socioeconomic Status Source Strategic Planning Stroke Subgroup System Treatment outcome Underrepresented Populations United States United States National Institutes of Health Vulnerable Populations Woman Women&apos s Health age related aging population beneficiary care outcomes clinical practice cohort cost demographics disability disadvantaged population disorder prevention dual eligible experience health data health disparity high risk population hospitalization rates human old age (65+)improved insight low socioeconomic status men national surveillance patient subsets population based post stroke programs racial and ethnic safety net social socioeconomic disadvantage socioeconomics stem stroke event stroke outcome stroke patient stroke risk stroke survivor surveillance data

项目摘要

Stroke is a major public health problem in the United States, with an estimated 800,000 strokes each year and an estimated 7 million stroke survivors. It is the third leading cause of death in women and the fifth leading cause in men. Twenty percent of stroke survivors require institutional care after 3 months and 15%-30% are permanently disabled. Stroke in adults is strongly age dependent. Because the United States population is aging, the population at risk for stroke will increase over the coming decades, and women will outnumber men in terms of stroke events. Another important shift in the US demographics is the increase of women of color, projected to increase from 36 percent to 53 percent of the total US female population. Improving stroke surveillance to fill important knowledge gaps in the burden of stroke for understudied, underrepresented, and underreported subgroups of women is critical to identify strategies to lessen the burden of stroke for women. This administrative supplement will build upon the Disparities in Patterns of Recurrent Stroke in the Elderly parent R01 grant to assess stroke rates and outcomes for fee-for-service and Medicare Advantage beneficiaries. Medicare administrative data will be used to achieve the following specific aims: 1) To describe patterns in stroke hospitalizations and outcomes for women in understudied racial/ethnic minority groups and geographic regions among elderly Medicare beneficiaries; and 2) To describe patterns of stroke rates and outcomes according to dual-eligible Medicare-Medicaid status and geographic region. Our proposed study will address research priorities identified by the NIH Strategic Plan for Women’s Health Research to develop information systems for collecting, sharing, and comparing clinical data for diseases and conditions of women as well as to examine health disparities among women stemming from differences in race/ethnicity and socioeconomic status. The study also addresses priorities identified by the National Institute on Aging, the Institute of Medicine, and National Institute of Neurological Disorders and Stroke to develop surveillance systems to understand the continuum of disease prevention, progression, treatment, and outcomes, particularly for vulnerable populations. Clinical practice, public policy, and reimbursement decisions are increasingly informed by administrative datasets. This study will be the most comprehensive and rigorous investigation to date aimed at describing stroke rates and outcomes among women from understudied, underrepresented, and underreported populations, including Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, and Native Hawaiians and other Pacific Islanders. The study will also examine the stroke rates and outcomes among elderly Medicare-Medicaid beneficiaries, one of the most socioeconomically vulnerable populations in the US healthcare system. Such information is needed to inform the clinical management of women and underserved subgroups of patients with stroke.

中风是美国的一个主要公共卫生问题，估计每年有80万中风，估计有700万笔中风存活。这是妇女的第三大死亡原因，也是第五领导男人的原因。 20％的中风生存需要3个月后的机构护理，而15％-30％为永久残疾。成年人中风非常依赖年龄。因为美国人口是衰老，有中风风险的人口将在未来几十年中增加，而妇女的人数将超过男性就中风事件而言。美国人口统计学的另一个重要转变是有色女性的增加，预计将从美国女性总人口的36％增加到53％。改进的中风监视以填补中风烧伤的重要知识空白，以理解，代表性不足和妇女的报表不足对于确定减轻女性中风负担的策略至关重要。这种行政补充将基于老年人中风的差异差异家长R01赠款评估笔中的中风率和成果的费用服务和Medicare Advantage 受益人。 Medicare行政数据将用于实现以下特定目的：1）描述在赛车/族裔少数民族群体中，男性中风住院和成果的模式古老的医疗保险受益人之间的地理区域； 2）描述中风率的模式和根据双重资格的Medicare Medicaid地位和地理区域的结果。我们提出的研究将解决NIH妇女健康研究战略计划确定的研究优先事项用于收集，共享和比较妇女疾病和状况的临床数据的信息系统以及研究因种族/种族差异而引起的妇女的健康差异社会经济地位。该研究还涉及国家老化研究所确定的优先事项医学研究所，国家神经系统疾病和中风研究所，以发展监视了解预防疾病，进展，治疗和结果的连续体的系统，特别是对于弱势群体。临床实践，公共政策和报销决定是行政数据集越来越多地告知。这项研究将是最全面，最严格的迄今为止的调查旨在描述从理解的女性中的中风率和结果 underrepresented, and underreported populations, including Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, and Native Hawaiians and other Pacific Islanders.这 study will also examine the stroke rates and outcomes among olderly Medicare-Medicaid beneficiaries, one of The most socioeconomically vulnerable populations in the US healthcare system. Such information is needed to inform the clinical management of women and underserved subgroups of patients with stroke.