Dissertation/Thesis Abstract

The Florida Agricultural and Mechanical University College of Pharmacy and Pharmaceutical Sciences
by Moore, Jaleesa, D.P.H., Florida Agricultural and Mechanical University, 2018, 121; 10838247
Abstract (Summary)

Introduction: During 2017, approximately 750,000 strokes occurred, of those approximately 140,000 people died from a stroke and <10% were also diagnosed with a hospital acquired condition. The economic burden associated with stroke care exceeds $34 billion; and hospitalizations with a hospital acquired condition increase costs. In the United States, differences in health outcomes have been documented; however, these studies show that sociodemographic differences continue to exist. The objectives of this study are to assess differences in clinical outcomes among the study population, and to assess if there are differences hospital charges.

Methods: To investigate differences in outcomes and hospital charges among the study population, the 2001-2011 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database was used. Hospitalizations that occurred with a primary diagnosis of an ischemic stroke and a subsequent diagnosis of a hospital acquired condition were queried using ICD-9 codes. Additionally, the Elixhauser comorbidity index was used to identify comorbid conditions among individuals hospitalized. To assess the differences in outcomes and hospital charges chi-square, logistic regression, and hierarchical multilevel modeling procedures were used. All statistical analyses were performed using SAS 9.4.

Results: The overall death rate has decreased among the study population; however, racial/ethnic differences exist in patient outcomes. When assessing hospital charges, hospitalizations that occurred in the Southern region of the United States were higher than hospitalizations that occurred in the Northwest region of the United States.

Conclusion: Further analysis needs to be conducted to assess sociodemographic differences in clinical outcomes among the study population. There is a need to continue to identify sociodemographic groups with risks of mortality to better guide the funding opportunities to target these resources to populations that experience the worse health outcomes. Future studies should also assess the role of mental health, cultural competency, and care coordination to improve patient outcomes.

Indexing (document details)
Advisor: Dutton, Matthew
Commitee: Ali, Askal, Baker, Charlotte, Rust, George, Tawk, Rima
School: Florida Agricultural and Mechanical University
Department: Institute of Public Health
School Location: United States -- Florida
Source: DAI-B 79/12(E), Dissertation Abstracts International
Subjects: Biostatistics, Epidemiology
Keywords: Charges, HAC, HCUP, NIS, Stroke
Publication Number: 10838247
ISBN: 978-0-438-27664-2
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