Impact of Aging on Stroke Care: A National Perspective

描述（由研究者提供）：我们的目标是研究美国老龄化对中风护理的影响。 我们的申请建议对作为国家中风项目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（以前称为医疗保健融资管理局（HCFA））的一部分，旨在按州查看中风护理的质量指标。 R 03申请的具体目标和拟议分析超出了国家卒中项目拟议的分析和可用资金。 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的数据分析和分析）。 R 03奖将允许对国家中风项目数据库进行分析，以测量和了解美国各地与年龄相关的中风护理差异。 我们的分析将产生第一个全国性的图片，年龄如何影响老年中风患者入院治疗。 此外，该RO 3的结果将提供新的分析，这些分析对于告知计划的RO 1的设计和内容至关重要，该RO 1将纳入国家卒中项目的老年患者的住院治疗过程与长期结局联系起来。 本提案的目的是提供关于老龄化如何直接影响卒中护理以及通过其与其他因素（包括人口统计学、临床共病、医院和医生特征以及地理位置）的关联的见解。 这些结果将是至关重要的，以加强临床决策和性能基准。 因此，我们设定了具体目标：1-确定年龄对急性缺血性卒中管理的影响; 2-确定年龄对卒中护理的影响在“卒中带”内是否不同; 3-检查医院和医生特征是否有助于卒中护理中与年龄相关的差异。 一些研究提出了关于人口统计学和临床因素如何影响脑血管疾病患者的护理和结局的问题，但关于这些因素如何具体影响老年卒中患者使用特定诊断技术和卒中治疗的数据很少。 我们假设护理存在年龄差异。 此外，这些护理差异不会被与衰老相关的临床特征或共病状况的差异所解释。

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.