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Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
Backgound: Few studies have examined associations among insurance status, treatment, and outcomes in patients hospitalized for intracerebral hemorrhage (ICH).Methods: Through retrospective analyses of the Get With The Guidelines (GWTG)-Stroke database, a national prospective stroke registry, from April 2003 to April 2011, we identified 95,986 nontransferred subjects hospitalized with ICH. Insurance status was categorized as Private/Other, Medicaid, Medicare, or None/Not Documented (ND). Associations between insurance status and in-hospital outcomes and quality of care measures were analyzed using patient- and hospital-spec...
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2013 Category: Neurology Authors: Michael L. James, Maria V. Grau-Sepulveda, DaiWai M. Olson, Eric E. Smith, Adrian F. Hernandez, Eric D. Peterson, Lee H. Schwamm, Deepak L. Bhatt, Gregg C. Fonarow Tags: Original Articles Source Type: research

Socioeconomic Disparities in the Utilization of Mechanical Thrombectomy for Acute Ischemic Stroke
We examined the utilization rates of mechanical thrombectomy by race/ethnicity (white, black, Hispanic, and Asian/Pacific Islander), income quartile (first, second to third, and fourth), and insurance status (Medicare, Medicaid, self-pay, and private). We also studied thrombectomy utilization rates at hospitals that performed thrombectomy.Results: From 2006 to 2010, 2,087,017 patients were hospitalized with a primary diagnosis of acute ischemic stroke; 8946 patients (.4%) received mechanical thrombectomy. Compared with white patients, black patients had significantly lower rates of overall mechanical thrombectomy utilizati...
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2013 Category: Neurology Authors: Waleed Brinjikji, Alejandro A. Rabinstein, Harry J. Cloft Tags: Original Articles Source Type: research

Race-Ethnic Disparities in 30-Day Readmission After Stroke Among Medicare Beneficiaries in the Florida Stroke Registry
Objective: To examine racial/ethnic disparities in 30-day all-cause readmission after stroke. Methods: Thirty-day all-cause readmission was compared by race/ethnicity among Medicare fee-for-service beneficiaries discharged for ischemic stroke from hospitals in the Florida Stroke Registry from 2010 to 2013. We fit a Cox proportional hazards model that censored for death and adjusted for age, sex, length of stay, discharge home, and comorbidities to assess racial/ethnic differences in readmission.
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2019 Category: Neurology Authors: Hannah Gardener, Erica C. Leifheit, Judith H. Lichtman, Kefeng Wang, Yun Wang, Carolina M. Gutierrez, Maria A. Ciliberti-Vargas, Chuanhui Dong, Mary Robichaux, Jose G. Romano, Ralph L. Sacco, Tatjana Rundek, FL-PR CReSD Investigators and Collaborators Source Type: research

A quantitative analysis of the effect of continuity of care on 30-day readmission and in-hospital mortality among patients with acute ischemic stroke
Ischemic stroke patients are predisposed to 30-day readmissions and mortality. An evaluation of readmission rates among patients with acute ischemic strokes from several studies highlighted that a 30-day readmission rate among Medicare beneficiaries are between 12.4% and 14.4%1,2 and there is a 2.5 fold increase risk of mortality among ischemic stroke patients readmitted within 30 days.3 Additionally, evidence suggest that up to 29% of rehospitalized patients with ischemic stroke were associated with inadequate outpatient continuum of care.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Arinze Nkemdirim Okere, Vassiki Sanogo, Rajesh Balkrishnan, Vakaramoko Diaby Source Type: research

The Patterns and Outcomes of Inter-Hospital Transfer Among Medicare Patients with Ischemic Stroke
This study aimed to understand the national patterns and outcomes of ischemic stroke transfer.
Source: Journal of Stroke and Cerebrovascular Diseases - September 26, 2020 Category: Neurology Authors: Shumei Man, Anne S. Tang, Jesse D. Schold, Murali K. Kolikonda, Ken Uchino Source Type: research

Disease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study
We examined outcomes and Medicare payments following any severity IS or TIA as well as the subgroup with minor IS or high-risk TIA.
Source: Journal of Stroke and Cerebrovascular Diseases - October 23, 2020 Category: Neurology Authors: Brystana G. Kaufman, Shreyansh Shah, Anne S. Hellkamp, Barbara L. Lytle, Gregg C. Fonarow, Lee H. Schwamm, Eva Les én, Jonatan Hedberg, Amarjeet Tank, Edmond Fita, Narinder Bhalla, Nipun Atreja, Janet Prvu Bettger Source Type: research

Intra-arterial Stroke Treatment prior to the Stent-Retriever Era: High Mortality and Lack of Volume –Outcome Association
Mechanical thrombectomy for acute large-vessel occlusive stroke is beneficial when performed with stent-retriever devices; however, little is known about real-world experience with intra-arterial treatment (IAT). We aimed to clarify how hospitals influence outcomes for Medicare thrombectomy patients to inform future delivery of effective mechanical thrombectomy treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - July 28, 2016 Category: Neurology Authors: Aditya S. Pandey, William J. Meurer, Neeraj Chaudhary, Joseph J. Gemmete, B. Gregory Thompson, Lewis B. Morgenstern, James F. Burke Source Type: research

Case Fatality Decline from 2009 to 2013 among Medicare Beneficiaries with Ischemic Stroke
This study aimed to examine the temporal trend of 30-day and 1-year mortality among U.S. Medicare beneficiaries who were hospitalized for ischemic stroke, with special focus on the mortality among subgroup of patients in relation to acute reperfusion therapies including intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT).
Source: Journal of Stroke and Cerebrovascular Diseases - December 9, 2019 Category: Neurology Authors: Shumei Man, Jesse D. Schold, Ken Uchino Source Type: research

National Institutes of Health Stroke Scale Correlates Well with Initial Intracerebral Hemorrhage Volume
The US Centers for Medicare and Medicaid Services (CMS) currently publicly reports hospital-quality, risk-adjusted mortality measure for ischemic stroke but not intracerebral hemorrhage (ICH). The NIHSS, which is captured in CMS administrative claims data, is a candidate metric for use in ICH risk adjustment and has been shown to predict clinical outcome with accuracy similar to the ICH Score. Correlation between early NIHSS and initial ICH volume would further support use of the NIHSS for ICH risk adjustment.
Source: Journal of Stroke and Cerebrovascular Diseases - February 10, 2022 Category: Neurology Authors: Salman Farooq, Kristina Shkirkova, Pablo Villablanca, Nerses Sanossian, David S. Liebeskind, Sidney Starkman, Gilda Avila, Latisha Sharma, May Kim-Tenser, Suzie Gasparian, Marc Eckstein, Robin Conwit, Scott Hamilton, Jeffrey L. Saver Tags: Original Article Source Type: research

Rate and Predictors of Acute Care Encounters in the First Month After Stroke
Hospital readmission has become an important quality metric, especially after the Affordable Care Act mandated a reduction in payments to hospitals with readmission rates higher than expected.1 The Centers for Medicare and Medicaid Services (CMS) defines 30-day stroke readmission as a hospital-specific readmission for any cause, except for certain planned readmissions, within 30 days after the date of discharge of the index admission.2 This definition does not take in account patients who are readmitted to other hospitals.
Source: Journal of Stroke and Cerebrovascular Diseases - April 4, 2022 Category: Neurology Authors: Haitham M. Hussein, Ella A. Chrenka, Amanda A. Herrmann Source Type: research

Hospital Quality Metrics: “America's Best Hospitals” and Outcomes After Ischemic Stroke
Background: Developing quality metrics to assess hospital-level care and outcomes is increasingly popular in the United States. The U.S. News& World Report ranking of “America's Best Hospitals” is an existing, popular hospital-profiling system, but it is unknown whether top-ranked hospitals in their report have better outcomes according to other hospital quality metrics such as the Centers for Medicare and Medicaid Services (CMS) publicly reported 30-day stro ke measures. Methods: The analysis was based on the 2015-2016 U.S.
Source: Journal of Stroke and Cerebrovascular Diseases - November 8, 2018 Category: Neurology Authors: Judith H. Lichtman, Erica C. Leifheit, Yun Wang, Larry B. Goldstein Source Type: research

Disparities in Inter-hospital Helicopter Transportation for Hispanics by Geographic Region: A Threat to Fairness in the Era of Thrombectomy
Background and Purpose: Mechanical thrombectomy (MT) is a time-dependent therapy that is only available at a limited number of hospitals. As such, patients that live at a considerable distance of those specialized centers often require rapid interhospital emergent evacuation with Helicopter Emergency Medical Services (HEMS) to be considered for MT. It is not known whether the use of HEMS is equitable across different groups of patients. Methods: Acute ischemic stroke patients emergently transferred to another facility were identified in a retrospective review of a large Medicare claims database.
Source: Journal of Stroke and Cerebrovascular Diseases - December 11, 2018 Category: Neurology Authors: Mary Vaughan Sarrazin, Kaustubh Limaye, Edgar A. Samaniego, Sami Al Kasab, Ali Sheharyar, Sudeepta Dandapat, Waldo R. Guerrero, David M. Hasan, Santiago Ortega-Gutierrez, Colin P. Derdeyn, James C. Torner, Angel Chamorro, Enrique C. Leira Source Type: research