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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80万人中风，估计有七百万中风幸存者它是妇女死亡的第三大原因，因为在男人身上。20%的中风幸存者在3个月后需要机构护理，15%-30%的人在3个月后需要机构护理。永久残疾。成年人的中风具有很强的年龄依赖性。因为美国人口随着老龄化，中风风险人口将在未来几十年内增加，女性人数将超过男性。在中风事件方面。美国人口统计的另一个重要变化是有色人种女性的增加，预计将从美国女性总人口的36%增加到53%。改善中风监测以填补研究不足、代表性不足和低报的女性亚组对于确定减轻女性中风负担的策略至关重要。这一行政补充将建立在老年人复发性卒中模式的差异基础上父母R 01补助金，用于评估按服务收费和Medicare Advantage的中风率和结局受益者。医疗保险管理数据将用于实现以下具体目标：1）描述研究不足的种族/少数民族群体中女性的卒中住院模式和结局，老年医疗保险受益人的地理区域;和2）描述中风率和根据双重资格的Medicare-Medicaid状态和地理区域的结果。我们建议的研究将解决NIH妇女健康研究战略计划确定的研究优先事项，收集、分享和比较妇女疾病和状况临床数据的信息系统以及审查因种族/族裔不同而造成的妇女健康差距，社会经济地位。这项研究还涉及国家老龄问题研究所确定的优先事项，医学研究所和国家神经疾病和中风研究所开发监测了解疾病预防、进展、治疗和结果的连续性的系统，特别是对弱势群体。临床实践、公共政策和报销决定是越来越多地通过行政数据库获得信息。这项研究将是最全面和严格的迄今为止的调查旨在描述未充分研究的女性中的中风率和结果，代表性不足和报告不足的人口，包括黑人/非裔美国人，西班牙裔/拉丁美洲人，美洲印第安人/阿拉斯加原住民、亚裔美国人、夏威夷原住民和其他太平洋岛民。的研究还将检查老年医疗保险-医疗补助受益人的中风率和结果，美国医疗体系中社会经济最脆弱的人群。需要这些信息，告知妇女和服务不足的中风患者亚组的临床管理。