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Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis
OBJECTIVE: Social determinants of health (SDH) have previously demonstrated to be important risk factors in determining health outcomes. To document whether the SDH are associated with hospitalisations for ischaemic stroke. METHODS: This cross-sectional study examines data from fiscal year 2015. Pat...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6999678/ https://www.ncbi.nlm.nih.gov/pubmed/32076565 http://dx.doi.org/10.1136/openhrt-2019-001189 |
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author | Wang, Andrew Kho, Abel N French, Dustin D |
author_facet | Wang, Andrew Kho, Abel N French, Dustin D |
author_sort | Wang, Andrew |
collection | PubMed |
description | OBJECTIVE: Social determinants of health (SDH) have previously demonstrated to be important risk factors in determining health outcomes. To document whether the SDH are associated with hospitalisations for ischaemic stroke. METHODS: This cross-sectional study examines data from fiscal year 2015. Patients from the national Medicare 100% Inpatient Limited Dataset were linked with SDH measures from the Robert Wood Johnson Foundation (RWJF) County Health Rankings. Medicare patients were included in the study group if they had either an admitting or primary diagnosis of ischaemic stroke. Counties without RWJF data were excluded from the study. Ischaemic strokes were compared with all other hospitalisations associated with characteristics of the SDH measures and benchmarked to above or below their respective national median. Estimates were performed with nested logistic regression. RESULTS: Approximately 256 766 Medicare patients had ischaemic stroke hospitalisations compared with all other Medicare patients (n=6 386 180) without ischaemic stroke hospitalisations while 30 853 patients were excluded due to residence in US territories. Significant factors included air pollution exceeding the national median (OR 1.06; 95% CI 1.05 to 1.07), per cent of children in single parent households exceeding the national median, (OR 1.02; 95% CI 1.01 to 1.03), violent crime rates exceeding the national median, (OR 1.02; 95% CI 1.01 to 1.03) and per cent smoking exceeding the national median, (OR 1.02; 95% CI 1.01 to 1.03). CONCLUSIONS: When cross-sectional SDH are benchmarked to national median for ischaemic stroke hospitalisations and compared with all-cause hospitalisations, the effects remain significant. Further research on the longitudinal effects of the SDH and cardiovascular health, particularly disease-specific outcomes, is needed. |
format | Online Article Text |
id | pubmed-6999678 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-69996782020-02-19 Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis Wang, Andrew Kho, Abel N French, Dustin D Open Heart Cardiac Risk Factors and Prevention OBJECTIVE: Social determinants of health (SDH) have previously demonstrated to be important risk factors in determining health outcomes. To document whether the SDH are associated with hospitalisations for ischaemic stroke. METHODS: This cross-sectional study examines data from fiscal year 2015. Patients from the national Medicare 100% Inpatient Limited Dataset were linked with SDH measures from the Robert Wood Johnson Foundation (RWJF) County Health Rankings. Medicare patients were included in the study group if they had either an admitting or primary diagnosis of ischaemic stroke. Counties without RWJF data were excluded from the study. Ischaemic strokes were compared with all other hospitalisations associated with characteristics of the SDH measures and benchmarked to above or below their respective national median. Estimates were performed with nested logistic regression. RESULTS: Approximately 256 766 Medicare patients had ischaemic stroke hospitalisations compared with all other Medicare patients (n=6 386 180) without ischaemic stroke hospitalisations while 30 853 patients were excluded due to residence in US territories. Significant factors included air pollution exceeding the national median (OR 1.06; 95% CI 1.05 to 1.07), per cent of children in single parent households exceeding the national median, (OR 1.02; 95% CI 1.01 to 1.03), violent crime rates exceeding the national median, (OR 1.02; 95% CI 1.01 to 1.03) and per cent smoking exceeding the national median, (OR 1.02; 95% CI 1.01 to 1.03). CONCLUSIONS: When cross-sectional SDH are benchmarked to national median for ischaemic stroke hospitalisations and compared with all-cause hospitalisations, the effects remain significant. Further research on the longitudinal effects of the SDH and cardiovascular health, particularly disease-specific outcomes, is needed. BMJ Publishing Group 2020-01-08 /pmc/articles/PMC6999678/ /pubmed/32076565 http://dx.doi.org/10.1136/openhrt-2019-001189 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Cardiac Risk Factors and Prevention Wang, Andrew Kho, Abel N French, Dustin D Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
title | Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
title_full | Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
title_fullStr | Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
title_full_unstemmed | Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
title_short | Association of the Robert Wood Johnson Foundations’ social determinants of health and Medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
title_sort | association of the robert wood johnson foundations’ social determinants of health and medicare hospitalisations for ischaemic strokes: a cross-sectional data analysis |
topic | Cardiac Risk Factors and Prevention |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6999678/ https://www.ncbi.nlm.nih.gov/pubmed/32076565 http://dx.doi.org/10.1136/openhrt-2019-001189 |
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