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Published in: BMC Health Services Research 1/2021

Open Access 01-12-2021 | Stroke | Research article

Differences in healthcare visit frequency and type one year prior to stroke among young versus middle-aged adults

Authors: Brandi L. Vollmer, Xing Chen, Erin R. Kulick, Mitchell S. V. Elkind, Amelia K. Boehme

Published in: BMC Health Services Research | Issue 1/2021

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Abstract

Background

The incidence and prevalence of stroke among the young are increasing in the US. Data on healthcare utilization prior to stroke is limited. We hypothesized those < 45 years were less likely than those 45–65 years old to utilize healthcare in the 1 year prior to stroke.

Methods

Patients 18–65 years old who had a stroke between 2008 and 2013 in MarketScan Commercial Claims and Encounters Databases were included. We used descriptive statistics and logistic regression to examine healthcare utilization and risk factors between age groups 18–44 and 45–65 years. Healthcare utilization was categorized by visit type (no visits, inpatient visits only, emergency department visits only, outpatient patient visits only, or a combination of inpatient, outpatient or emergency department visits) during the year prior to stroke hospitalization.

Results

Of those 18–44 years old, 14.1% had no visits in the year prior to stroke compared to 11.2% of individuals aged 45–65 [OR = 1.30 (95% CI 1.25,1.35)]. Patients 18–44 years old had higher odds of having preventive care procedures associated with an outpatient visit and lower odds of having cardiovascular procedures compared to patients aged 45–65 years. Of stroke patients aged 18–45 and 45–65 years, 16.8 and 13.2% respectively had no known risk for stroke.

Conclusions

Patients aged 45–65 were less commonly seeking preventive care and appeared to be seeking care to manage existing conditions more than patients aged 18–44 years. However, as greater than 10% of both age groups had no prior risk, further exploration of potential risk factors is needed.
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Literature
6.
go back to reference Adams HP Jr, Kappelle LJ, Biller J, Gordon DL, Love BB, Gomez F, Heffner M. Ischemic stroke in young adults. Experience in 329 patients enrolled in the Iowa registry of stroke in young adults. Arch Neurol. 1995;52(5):491–5.CrossRef Adams HP Jr, Kappelle LJ, Biller J, Gordon DL, Love BB, Gomez F, Heffner M. Ischemic stroke in young adults. Experience in 329 patients enrolled in the Iowa registry of stroke in young adults. Arch Neurol. 1995;52(5):491–5.CrossRef
12.
go back to reference Arcari CM, Gaydos CA, Nieto FJ, Krauss M, Nelson KE. Association between chlamydia pneumoniae and acute myocardial infarction in young men in the United States military: the importance of timing of exposure measurement. Clin Infect Dis. 2005;40(8):1123–30. https://doi.org/10.1086/428730.CrossRefPubMed Arcari CM, Gaydos CA, Nieto FJ, Krauss M, Nelson KE. Association between chlamydia pneumoniae and acute myocardial infarction in young men in the United States military: the importance of timing of exposure measurement. Clin Infect Dis. 2005;40(8):1123–30. https://​doi.​org/​10.​1086/​428730.CrossRefPubMed
13.
go back to reference Bova IY, Bornstein NM, Korczyn AD. Acute infection as a risk factor for ischemic stroke. Stroke. 1996;27(12):2204–6.CrossRef Bova IY, Bornstein NM, Korczyn AD. Acute infection as a risk factor for ischemic stroke. Stroke. 1996;27(12):2204–6.CrossRef
19.
go back to reference Villarroel M, Blackwell D, Jen A. Tables of Summary Health Statistics for U.S. Adults: 2018 National Health Interview Survey: National Center for Health Statistics; 2019. Villarroel M, Blackwell D, Jen A. Tables of Summary Health Statistics for U.S. Adults: 2018 National Health Interview Survey: National Center for Health Statistics; 2019.
20.
go back to reference Abraham MK, Chang W-TW. Subarachnoid hemorrhage. Emerg Med Clin North Am. 2016;34(4):901–16.CrossRef Abraham MK, Chang W-TW. Subarachnoid hemorrhage. Emerg Med Clin North Am. 2016;34(4):901–16.CrossRef
21.
go back to reference Databases. IRBaMR: 2017 IBM marketscancommercial claims and encounters medicare supplemental and coordination of benefits data dictionary 2018. Databases. IRBaMR: 2017 IBM marketscancommercial claims and encounters medicare supplemental and coordination of benefits data dictionary 2018.
22.
go back to reference Rui P, Okeyode T: National Ambulatory Medical Care Survey: 2016 National Summary Tables. Rui P, Okeyode T: National Ambulatory Medical Care Survey: 2016 National Summary Tables.
26.
go back to reference CDC: Flu Vaccination Coverage, United States, 2018–19 Influenza Season. 2019. CDC: Flu Vaccination Coverage, United States, 2018–19 Influenza Season. 2019.
Metadata
Title
Differences in healthcare visit frequency and type one year prior to stroke among young versus middle-aged adults
Authors
Brandi L. Vollmer
Xing Chen
Erin R. Kulick
Mitchell S. V. Elkind
Amelia K. Boehme
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-021-06064-5

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