[Hospitalizations for acute cerebrovascular accidents and transient ischemic attacks in Spain: temporal stability and spatial heterogeneity, 1998-2003].
BACKGROUND
Stroke is a leading cause of hospitalisation. Ageing and differences in management and specialisation between health centres could explain the variability in hospitalisation and prognosis between areas. We analyse the number of hospitalisations due to stroke and TIA (Spain), 1998-2003, and the differences between regions.


METHODS
The Spanish Ministry of Health, through its MBDS (Minimum Basic Data Set Office), provided data for stroke and TIA hospitalisation. Diagnoses were extracted according to ICD-9 (International Classification of Diseases) -codes 430-439- and to GRD (Group Related Diagnoses) -codes 14-17, 532, 810-. We included: a) autonomous community identification; b) average stay; c) age, sex, type of discharge (mortality); d) number of diagnoses, weight/cost for GRD.


RESULTS
There was ateady temporal incidence of hospitalisation for stroke (GRD14, 160/100,000) and TIA (GRD15, 55/100,000). Weight and costs increased between 2000 and 2003, and reached 3,400 euro (GRD14) and 2,400 euro (GRD15). Average stay decreased from 12 to 10.1 days (stroke) and 8.6 to 7.3 days (TIA). Mortality also decreased from 12.7% to 9.2% for stroke (GRD14). The average number of diagnoses was similar for stroke and TIA: both increased from 4 to 5 over the 6 years. There were wide variations between autonomous communities in hospitalisations for stroke and TIA: from 250/100,000 to less than 120/100,000. There was a correlation between the ageing of the populations and these differences. There were also wide variations (up to 40%) in average stay and mortality between communities.


CONCLUSIONS
Hospitalisation rate for stroke and TIA is very high and sustained; despite increasing complexity, average stay and mortality improved, which points to better management. Variability among regions is highlighted. Further prospective studies are required.
Servicio de Neurología, Hospital de Basurto, Avda. de Montevideo 18, Bilbao, Spain. luiscarlos.alvarogonzalez@.osakidetza.net
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D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors