Key result
Black (OR 1.21; 95% CI 1.06-1.39) and Hispanic (OR 1.54; 95% CI 1.29-1.85) patients had a higher likelihood of severe ischemic stroke compared to White patients, compounded by dual eligibility.
Why the study?
Little is known about differences in stroke severity for individuals with dual Medicare-Medicaid eligibility, Black individuals, and Hispanic individuals, but understanding admission severity is essential for focusing strategies to reduce disparities.
Are dual Medicare-Medicaid eligibility and minority race/ethnicity associated with worse ischemic stroke severity upon hospital admission?
Population
45 459 Medicare fee-for-service patients aged 66 and older admitted with ischemic stroke
Comparison
Dual Medicare-Medicaid eligibility and race/ethnicity groups vs non-dual-eligible White patients
Design
Retrospective cross-sectional study
Authors
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Does not support immediate changes in stroke triage; leaves open causal pathways linking dual eligibility to racial disparities in severity.
Cross-Sectional (n=45,459)
Yes
Are dual Medicare-Medicaid eligibility and minority race/ethnicity associated with worse ischemic stroke severity upon hospital admission?
Odds Ratio: 1.21 (95% CI 1.06–1.39)
Dual Medicare-Medicaid eligibility and Black or Hispanic race/ethnicity are independently and synergistically associated with worse ischemic stroke severity upon hospital admission.
Bosch et al. (2022) conducted a cross-sectional in ischemic stroke (n=45,459). Black or Hispanic race and Medicare-Medicaid dual eligibility vs. White race and no dual eligibility was evaluated on severe stroke (OR 1.21, 95% CI 1.06-1.39). Black (OR 1.21; 95% CI 1.06-1.39) and Hispanic (OR 1.54; 95% CI 1.29-1.85) patients had a higher likelihood of severe ischemic stroke compared to White patients, compounded by dual eligibility.
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