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Original Article| Volume 23, ISSUE 2, e93-e98, February 2014

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Disparities in Acute Stroke Severity, Outcomes, and Care Relative to Health Insurance Status

Published:October 07, 2013DOI:https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.08.027
Disparities in Acute Stroke Severity, Outcomes, and Care Relative to Health Insurance Status
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      Background

      To examine the differences in risk factors and length of hospital stay (LOS) between the insured and uninsured stroke patients, identifying the root causes of increasing hospital stay.

      Methods

      Retrospective analysis of stroke registry data of acute stroke patients (N = 19,255) was analyzed to compare risk factors, severity, outcome, and LOS by insurance status. Chart review of patients from a comprehensive stroke center (N = 3290) was studied in greater detail for causes of extended length of stay.

      Results

      The uninsured patients had poorer control of risk factors and statistically significantly (P < .0001) higher initial stroke severity, mortality, and LOS as compared with insured patients (3.8 versus 4.5 days, respectively). The increased length of stay was largely accounted for by the inability to transfer uninsured patients to inpatient rehabilitation settings.

      Conclusion

      This study highlights the need for public policies that provide funding for both primary stroke prevention and poststroke rehabilitation.

      Key Words

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      Article info

      Publication history

      Published online: October 07, 2013
      Accepted: August 29, 2013
      Received in revised form: August 14, 2013
      Received: April 11, 2013

      Identification

      DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.08.027

      Copyright

      © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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