Impact of Aging on Stroke Care: A National Perspective

描述(由研究人员提供)：我们的目标是研究老龄化对美国中风护理的影响。我们的应用程序建议对作为国家中风项目的一部分收集的数据进行二次分析。国家中风项目是医疗保险和医疗补助研究中心(CMS)计划(前身为医疗保健融资管理局(HCFA))的一部分，该计划旨在研究各州中风护理的质量指标。R03申请的具体目标和建议的分析超出了国家中风项目建议的分析和可获得的资金。我们的应用程序非常适合PA编号：PA-01-082(人口统计学、经济学和老龄化行为研究中的数据分析和归档)。R03奖将允许对国家中风项目数据库进行分析，该数据库与测量和了解全美中风护理中与年龄相关的差距有关。我们的分析将产生第一张关于年龄如何影响住院老年中风患者护理的全国性图片。此外，这项R03的结果将提供新的分析，为计划的RO1的设计和内容提供信息，该RO1将国家中风项目中包括的老年患者的住院护理过程与长期结果联系起来。这项建议的目的是洞察老龄化如何直接影响中风护理，并通过其与其他因素的关联来影响中风护理，包括人口统计学、临床合并症、医院和医生特征以及地理位置。这些结果将对加强临床决策和绩效基准至关重要。因此，我们制定了具体的目标：1-确定年龄对急性缺血性中风治疗的影响；2-确定年龄对中风治疗的影响是否在“中风带”内不同；以及3-检查医院和医生的特征是否导致与年龄相关的中风治疗的差异。一些研究提出了一些问题，即人口统计和临床因素如何影响脑血管疾病患者的护理和结果的变化，但关于这些因素如何具体影响老年中风患者使用特定诊断技术和中风治疗的数据很少。我们假设护理随年龄的变化而存在差异。此外，这些护理上的差异不能用不同的临床特征或与衰老相关的共病情况来解释。

DESCRIPTION (provided by investigator): Our goal is to examine the impact of aging on stroke care in the United States. Our application proposes secondary analysis of data collected as part of the National Stroke Project. The National Stroke Project was part of a Center for Medicare and Medicaid Study (CMS) program (formerly know as the Health Care Financing Administration (HCFA)) to look at quality indicators for stroke care by state. The specific aims and proposed analyses of this R03 application go beyond the analyses proposed, and funding available for, the National Stroke Project. Our application is ideally suited to PA Number: PA-01-082 (Data analysis and Archiving in Demography, Economics, and Behavioral Research on Aging). The R03 Award will permit an analysis of the National Stroke Project database related to measuring and understanding the age-related disparities in stroke care across the United States. Our analyses will yield the first national picture of how age influences the care of elderly patients admitted to the hospital with stroke. In addition, the results of this RO3 will provide new analyses critical to informing the design and content of a planned RO1 linking processes of inpatient care from the elderly patients included in the National Stroke Project with long-term outcomes. The objective of this proposal is to provide insight into how aging influences stroke care both directly and through its association with other factors including demographics, clinical co-morbidities, hospital and physician characteristics, and geography. These results will be critical to enhancing clinical decision-making and performance benchmarking. Accordingly we have set specific aims: 1-to determine the influence of age on the management of acute ischemic stroke; 2-to determine if the impact of age on stroke care is different within the 'Stroke Belt'; and 3-to examine whether hospital and physician characteristics contribute to age related differences in stroke care. Some studies have raised questions about how demographic and clinical factors contribute to the variations seen in the care and outcomes of patients with cerebro-vascular disease, but few data are available regarding how these factors specifically affect the use of specific diagnostic techniques and stroke therapies in older patients with stroke. We hypothesize that variations in care exist by age. Moreover, these differences in care will not be explained by differences clinical features or co-morbid conditions associated with aging.