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Volume 45 Number 9, 2008
   Pages 1375 — 1384

Abstract - Factors associated with VHA costs of care for first 12 months after first stroke

Jeanne Hayes, PhD;1* Bruce Vogel, PhD;2-3 Dean M. Reker, PhD1

1Kansas City Department of Veterans Affairs (VA) Medical Center, Kansas City, MO; 2North Florida/South Georgia VA Medical Center, Gainesville, FL; 3Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, FL

Abstract — We examined the use patterns and costs of care for a validated stroke cohort (n = 172) from 13 Department of Veterans Affairs (VA) medical centers 1 year poststroke. Decision Support System (DSS) cost and use data (inpatient and outpatient) are profiled. We provide preliminary information about the costs associated with inpatient and outpatient care and explore the relationship between the cost of stroke care, location of service (inpatient and outpatient), and patient functional outcomes. Data on both clinical and sociodemographic characteristics were abstracted from the medical record and merged with VA DSS cost data from each patient's first year poststroke. Descriptive statistics assessed patterns in treatment costs. We found that DSS costs varied as expected across key indicators, including function, health status, discharge location, and the number of comorbidities. These findings provide broad support for the use of DSS cost data in studies of VA stroke care.

Key words: acute stroke care, Decision Support System, FIM, Modified Rankin Scale, rehabilitation care, stroke, stroke costs, Stroke Impact Scale, subacute stroke care, VA.

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