Stroke Hospitalization in the Elderly with Medicare FFS

老年人中风住院医疗保险 FFS

• 批准号: 7018467
• 负责人: JUDITH H LICHTMAN
• 金额: $ 27.89万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 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/7018467
• 关键词: Medicare /Medicaid; age difference; data collection; gender difference; geographic difference; health services research tag; hospital utilization; human mortality; longitudinal human study; outcomes research; racial /ethnic difference; socioeconomics; stroke

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）：该国缺乏一个连贯的、信息丰富的血管疾病监测系统，该系统可以深入了解脑血管疾病的国家模式，并揭示国家的长期趋势。我们的总体目标是建立一个监测系统，用于美国大多数因中风入院的患者，年龄> 65岁的患者，他们参加了医疗保险按服务收费（FFS）选项。我们通过为1992-1999年因血管诊断住院的患者创建纵向医疗保险数据库，收集了前所未有的国家资源，并能够增加年数（截至2003年，作为该项目的一部分）。自从我们最初提交以来，我们的团队克服了相当大的技术困难来创建这个数据库。这项工作需要将5 000多盘数据磁带转换成一个可使用的数据资源，其中包含超过1兆兆字节的数据。以前使用医疗保险数据库的研究采用了横截面方法，在患者层面上，整个医疗保险A部分（住院）数据库随着时间的推移没有联系起来。没有其他组织或机构，甚至医疗保险和医疗补助服务中心（CMS）也没有开发这样的数据库。我们的目标是提供最全面的评估中风和短期死亡率的结果之间住院的联邦医疗保险FFS受益人在美国。评估将涵盖整个美国，时间跨度超过十年。因此，我们提出以下具体目标：1。确定美国医疗保险受益人的中风住院率。2.确定美国医疗保险受益人中风住院后的住院死亡率和30天死亡率。3.确定亚组中卒中住院的模式，包括年龄、人种和种族，以及经济、政治和地理特征。4.我们的工作将有助于更好地确定老年人中风的负担，为政策制定者和临床医生规划中风患者的医疗保健需求提供信息，并帮助确定干预措施的目标，以加强对中风患者的护理。