+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Use of Medicare claims data to estimate national trends in stroke incidence, 1985-1991

Use of Medicare claims data to estimate national trends in stroke incidence, 1985-1991

Stroke 25(12): 2343-2347

Background and Purpose: Although stroke mortality has been declining in the United States for decades, recent trends in stroke incidence based on national data have not been described. We used Medicare hospitalization data to estimate national trends in the incidence of stroke among Americans aged 70 years or older, and we provide evidence of the validity of the estimate. Methods: We defined stroke as a principal diagnosis with International Classification of Diseases, 9th Revision, Clinical Modification codes 430 to 434 or 436 to 437. We excluded many recurrent cases from the analysis by eliminating persons hospitalized for stroke during the 5 years preceding the index stroke. We calculated annual adjusted incidence rates and examined trends graphically. We investigated the effect of different exclusion periods, trends in in-hospital mortality of stroke patients, and trends in out-of-hospital stroke mortality. We examined trends in relation to sex, race and age. Results: The estimated age- and sex-adjusted stroke incidence declined 9.5% from 1985 to 1989, then increased 3.3% to 1991. The pattern did not vary with the length of the exclusion period or when all listed diagnoses rather than principal diagnoses were used to identify stroke cases. Incidence trends resembled the overall trend for both men and women, for 5-year age groups, and for whites; the trend did not change for blacks. Conclusions: Stroke incidence declined steadily from 1985 to 1981) and then increased slightly to 1991. Several postulated potential sources of bias were investigated and found to be unlikely to account for the incidence decline, although some may have contributed to the subsequent incidence increase.

(PDF emailed within 0-6 h: $19.90)

Accession: 009702598

Download citation: RISBibTeXText

PMID: 7974571

DOI: 10.1161/01.str.25.12.2343

Related references

Validity of claims-based stroke algorithms in contemporary Medicare data: reasons for geographic and racial differences in stroke (REGARDS) study linked with medicare claims. Circulation. Cardiovascular Quality and Outcomes 7(4): 611-619, 2015

National specialty trends in billable diagnostic ultrasound in the ED: analysis of Medicare claims data. American Journal of Emergency Medicine 32(12): 1470-1475, 2015

Trends in incidence, case-fatality rate, and severity of stroke in northern Sweden, 1985-1991. Stroke 25(9): 1738-1745, 1994

Stroke incidence is decreasing in whites but not in blacks: a population-based estimate of temporal trends in stroke incidence from the Greater Cincinnati/Northern Kentucky Stroke Study. Stroke 41(7): 1326-1331, 2010

Trends in Diabetes Incidence in the Last Decade Based on Korean National Health Insurance Claims Data. Endocrinology and Metabolism 31(2): 292-299, 2016

Trends in survival and recovery from stroke: evidence from the National Long-Term Care Survey/Medicare data. Stroke 41(3): 563-565, 2010

Stroke incidence, comorbid conditions, health care utilization, and poststroke mortality in black and white medicare beneficiaries National patterns and trends. Gillum, R F , Gorelick, P B , Cooper, E S Stroke in blacks: A guide to management and prevention 106-117, 1999

Trends in syphilis incidence in Wisconsin, 1985-1991. Wisconsin Medical Journal 92(2): 67-72, 1993

Medicare claims data provide a perspective on trends in HAC rates. Healthcare Financial Management 70(1): 80-81, 2016

The epidemiology of hospitalization of elderly Americans for septicemia or bacteremia in 1991-1998. Application of Medicare claims data. Annals of Epidemiology 11(2): 118-126, 2001

National trends in percutaneous cholecystostomy between 1994 and 2009: perspectives from Medicare provider claims. Journal of the American College of Radiology 9(7): 474-479, 2012

Trends in the incidence of ischaemic stroke in young adults between 1985 and 2011: the Dijon Stroke Registry. Journal of Neurology, Neurosurgery, and Psychiatry 85(5): 509-513, 2014

Hospitalization for cardiac conduction disorders and arrhythmias in elderly Americans, 1991-1995 Application of Medicare claims data. Journal of Investigative Medicine 46(3): 212A, March, 1998

National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms. Urology, 2018

Analysis of incidence of and surgery for cancer using medicare claims data. Clinical Research 38(2): 724A, 1990