Abstract
Introduction: Mexican Americans (MAs) use less preventative healthcare than NHWs and this may result in in more emergency department (ED) visits or readmissions. We sought to explore ethnic differences in ED and hospital utilization immediately before and after stroke. Methods: BASIC is a stroke epidemiologic study in Corpus Christi TX. We performed probabilistic matching to identify hospital claims for all BASIC-identified index strokes (ischemic or ICH) from 2010-2020 continuously enrolled in Medicare fee-for-service (FFS). Matching was performed using demographics (including date of birth), stroke admission/discharge dates, vascular risk factors, comorbidities, and in-hospital procedures. All emergency department (ED) visits and hospital readmissions within 90 days before and after the index stroke were identified using Medicare claims. Logistic regression models were used to determine the association of MA ethnicity (compared to NHWs) with prior ED/inpatient visits and cox regression models were used to estimate the associations with subsequent ED visits/readmissions (censoring at death), adjusting for patient age, sex, stroke severity, and stroke type. Results: We identified 1,180 incident BASIC strokes that could be matched with Medicare FFS inpatient claims: 84% with ischemic stroke, 46.2% NHWs vs 45.7% MAs, mean age 76.4, median (IQR) NIHSS 5 (2-13). Both ED visits and hospitalizations were relatively common before and after stroke (Table). Compared to NHWs, MAs were more likely to have ED visits before stroke than NHWs (OR 1.5, 95%CI [1.1-2.1]) and hospitalizations after stroke (HR 1.3, [1.1-1.7], but no ethinc differences were observed in pre-stroke hospitalizations or post-stroke ED visits. ( Table ) Conclusion: The increased rate of pre-stroke ED visits in MAs suggests the potential for missed opportunities to prevent stroke may exist and merits further scrutiny.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.