Chicago — Having diabetes significantly increases the cost of treating stroke, particularly for African Americans, new research suggests.
An analysis of 18,847 stroke patients discharged from Tennessee hospitals in 2006 showed that 31% had diabetes. The stroke rate was 7% among diabetic patients versus 4% for nondiabetic patients. The difference was statistically significant.
Among African American women, the stroke rate was significantly higher in those with diabetes than in those without (8% vs. 5%). This trend was also found among the subgroups of African American men and white females and males, Baqar Husaini, Ph.D., and his associates reported in a poster at a meeting sponsored by the International Society on Hypertension in Blacks.
The average total treatment cost was $62,598 for diabetic stroke patients versus $45,344 for nondiabetic stroke patients, a significant difference. This could be due to diabetes complications that required longer hospitalization, said Dr. Husaini, director of the Center for Health Research, Tennessee State University, Nashville. The average hospital stay was 16 days for diabetes patients versus 11 days for nondiabetic patients, a significant difference.
Overall, patients with diabetes were significantly more likely than were those without diabetes to have hypertension (87% vs. 75%), a previous MI (10% vs. 7%), and heart failure (26% vs. 15%), but transient ischemic attacks (TIAs) were significantly less common among diabetes patients (6% vs. 8%).
Both stroke cost and total cost were significantly higher for African Americans than for whites within each diabetes subgroup, he reported. Among patients with diabetes, the stroke cost was $37,964 for African Americans, compared with $21,469 for whites. African American men had the highest stroke-related costs at $39,685, compared with $36,835 for African American women, $25,464 for white women, and $26,729 for white men.
“A higher rate of comorbidities among diabetic African Americans may contribute to longer hospitalization and additional clinical services, which constitute higher treatment costs,” the researchers reported.
Black men and women had higher rates of hypertension, TIAs, and diabetes than did white, but whites of both sexes had higher rates of previous MI. Women of both races were more likely than were men to have heart failure. The average age of the cohort was 70 years; 55% were female. Because the clinical data did not indicate the severity of patients' comorbid conditions, it is difficult to determine which factors contribute to racial differences in stroke treatment costs, the authors wrote.
The authors disclosed no conflicts of interest. The study was sponsored by the Centers for Disease Control and Prevention and the National Institute of Mental Health.
The average total was $62,598 for diabetic stroke patients versus $45,344 for nondiabetic stroke patients.
Source DR. HUSAINI