title: The effect of age and procedure on resource use for patients with cerebrovascular disease.
abstract: OBJECTIVE
  Many studies have described the impact of population ageing on health care expenditures, but few have assessed its impact on specific diseases adjusted for severity and procedure. This study examined the relationship between an ageing population and resource use in patients with cerebrovascular disease (CVD).
  
  
  METHODS
  A total of 13,856 CVD patients were treated in 82 academic and 92 community hospitals. Demographic variables, clinical variables, length of stay (LOS) and total charges were analysed by age group (under 65 years, 65-74 years and 75 years or older). The independent effects of age on LOS and total charge were determined using multivariate analysis.
  
  
  RESULTS
  There were 5172 (37%) patients under 65 years of age, 4096 (30%) 65-74 years and 4588 (33%) 75 years or older. Intracranial infarction or ischaemia was diagnosed in 69% of the patients, haemorrhage in 23% and subarachnoid haemorrhage in 9%. The overall mortality was 6% (5% in under 65 years, 5% in 65-74 years and 9% in 75 years or older; P<0.001). There were significant differences in the proportion of procedures performed in each age category. Age and procedure were significantly associated with LOS, particularly the latter. Age had no significant association with total charge, but procedure was highly associated.
  
  
  CONCLUSIONS
  Ageing has no significant impact on total charge. Instead policy-makers should acknowledge the effect of procedures on health care costs, conduct economic evaluations and monitor use of procedures.
authors.affiliation: Department of Health Care Administration and Management, Graduate School of Medicine, Kyushu University, Maidahi Higashiku, Fukuoka, Japan. kazu228@basil.ocn.ne.jp
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kuwabara
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Imanaka
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.forename: Hideki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: D000367:Age Factors; D000368:Aged; D002561:Cerebrovascular Disorders; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index