Objective
This study examined the impact of co-occurring chronic conditions on healthcare expenditures
among noninstitutionalized older adults (age ≥50 years) with stroke in comparison
to non–stroke-matched controls.
Methods
This study used a retrospective, cross-sectional, matched case-control design using
pooled 2002-2012 Medical Expenditure Panel Survey (MEPS) data. Stroke survivors (N = 2913)
were compared with matched controls (N = 8739) based on propensity scores. Healthcare
expenditures for co-occurring chronic conditions were compared between stroke survivors
and matched controls using ordinary least squares (OLS) regressions. All analyses
were conducted in SAS 9.4 (SAS Institute Inc., Cary, NC, USA) using survey procedures
adjusting for the complex survey design of the MEPS.
Results
The annual mean total healthcare expenditures (expressed in 2012 United States dollars)
were significantly higher among stroke survivors compared with matched non-stroke
controls ($18,796 versus $14,391, P < .001). OLS regressions revealed that co-occurring chronic conditions partially
explained the excess healthcare expenditures among stroke survivors. The annual mean
total healthcare expenditures among stroke survivors were significantly higher for
most of the co-occurring chronic conditions compared with matched controls (e.g.,
in presence of hyperlipidemia, stroke survivor expenditures were $18,807 compared
to $15,807 among matched controls). Stroke survivors with co-occurring arthritis,
diabetes, or hypertension had significantly greater inpatient, emergency room, and
prescription expenditures compared with matched controls.
Conclusions
Stroke survivors experience a high economic burden. Interdisciplinary team-based treatment
approaches to provide holistic care may help reduce the burden due to co-occurring
chronic medical conditions among stroke survivors.
Key Words
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Article info
Publication history
Published online: October 25, 2016
Accepted:
September 24,
2016
Received in revised form:
July 18,
2016
Received:
May 20,
2016
Footnotes
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.040
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
