Impact of Patients' Income on Stroke Prognosis.
BACKGROUND
For patients diagnosed with stroke, the association between socioeconomic status and patient outcomes is poorly understood. Our objective was to define the impact of patients' socioeconomic status on their prognosis after stroke in the United States.


METHODS
Utilizing the Nationwide Inpatient Sample, we identified discharges involving a diagnosis of stroke from 2008 to 2013. Cohort was dichotomized to low-income patients (L-patients) and not-low-income patients (NL-patients). Z-test statistic was used to test the impact of income on stroke outcome.


RESULTS
The reported annual total in-hospital mortality for L-patients and NL-patients diagnosed with stroke at U.S. hospitals decreased significantly during the study period (P < .001). The mortality of L-patients decreased significantly from 1759 (4.16%) to 955 (2.54%) during study period. Similarly, NL-patients' mortality decreased significantly from 4818 (4.52%) to 2300 (2.47%) during the same period. The difference between the annual total in-hospital mortality for L-patients and NL-patients due to stroke was statistically significant throughout the entire study period (P < .0001). Notably, from 2008 to 2013, the annual total routine discharges, annual total discharges to short-term hospital, annual total discharges to another institution, and annual total discharges to home health care were statistically significantly different between the 2 populations of patients (P < .0001).


CONCLUSIONS
Socioeconomic status has an impact on patient outcome after treatment of stroke in hospitals in the United States. Further study is needed to investigate the etiology of these differences between patients' socioeconomic status and their clinical outcomes after stroke.
Department of Neurosurgery. Electronic address: seifi@uthscsa.edu.
Ali
A
Seifi
School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Ross-Jordon
RJ
Elliott
School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Marwah A
MA
Elsehety
D015331:Cohort Studies; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D007902:Length of Stay; D008297:Male; D011379:Prognosis; D012923:Social Class; D020521:Stroke / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
Stroke; economics; mortality; neurological surgery; prognosis; socioeconomic status