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Abstract Details

Predictors of Readmission After Stroke in a Cohort of Privately Insured Patients
Cerebrovascular Disease and Interventional Neurology
S26 - Cerebrovascular Disease: Systems of Stroke Care (2:24 PM-2:36 PM)
008

The aim of this study is to examine factors associated with readmission after stroke in a privately insured cohort.

Reducing readmission rate is a healthcare priority. It is unknown whether regular primary care is effective in preventing readmission post-stroke.
Our organization is a health insurance provider and a healthcare provider. We retrospectively identified members of our insurance plan who discharged from one of our family of hospitals (one comprehensive stroke center, one primary stroke center, and two stroke ready hospitals) 2015-2018 with a stroke diagnosis excluding TIAs. Using insurance claims, we captured all inpatient readmissions within 30 days after discharge. We were able to identify primary care visits in the year preceding and the month following the index stroke. The impact of primary care was examined in a univariate analysis and a multivariate analysis adjusting for age, sex, race, stroke type, and length of stay (LOS).
We identified 872 patients after excluding those who were not members of our insurance plan and those whose readmission was planned (mean age 71±15 years; 53% women; 17% non-white). Stroke types were 83% ischemic stroke; 7% ICH; 5% SAH. Most common discharge destination was home 57% followed by skilled nursing facility 29%. Overall 30-day all-cause inpatient readmission rate was 10.1%. In an unadjusted model, there was a significant association between presence of primary care and probability of readmission (OR 0.51 [95% CI 0.28-0.92]; p=0.026). This association was borderline significant in the multivariate analysis (OR 0.56 [95% CI 0.30-0.1.06]; p=0.074). LOS and age were found to be independently associated with readmission. There was no association between readmission and sex, race or stroke type.
Established primary care is protective from stroke readmission. Utilization of primary care before and after stroke can be used to assess risk of readmission in stroke patients.
Authors/Disclosures
Haitham Hussein, MD, FAAN (University of Minnesota Medical School)
PRESENTER 		Dr. Hussein has nothing to disclose.
No disclosure on file
Amanda A. Herrmann, PhD (HealthPartners Neuroscience Center) No disclosure on file
No disclosure on file