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2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
Section
Six: Maps of Hospital
Charges for Stroke Hospitalizations
This section documents the geographic patterns of Medicare Part A total
charges for stroke hospitalizations among Medicare beneficiaries ages 65 and
older in 1995 and 2000. The maps depict the average hospital charge for each
county that Medicare received per stroke hospitalization in 1995 and in
2000. The data are not adjusted for variations in cost of living.
Total charges are defined by Medicare as what the hospital charges for
room, board, and ancillary services (e.g., nursing services, inpatient
prescription drugs, operating and recovery room use, laboratory tests) as
recorded on the billing form. Total charges are not the same as covered
charges or Medicare program payments. For additional information regarding
the types of Medicare costs, see the 2004 Health Care Financing Review,
Medicare and Medicaid Statistical Supplement, available at
http://www.cms.hhs.gov/HealthCareFinancingReview.
Total Charges for Stroke Hospitalizations, 1995
In 1995, a total of $6.34 billion was charged to Medicare for stroke
hospitalizations. The average charge to Medicare for a stroke
hospitalization was $12,477. Among the 3,187 counties examined in this
Atlas, the average charge per stroke hospitalization per county ranged from
$1,923 to $82,251. The frequency distribution indicates that for the
majority of counties, the average charge per stroke hospitalization ranged
from $8,000 to $15,000.
Counties with the highest average charges per stroke hospitalization (i.e.,
those in the top quintile, for which the average charge was $12,019 or
higher) were located in many parts of the United States, including Florida,
California, Arizona, and Hawaii. Counties in the top quintile were located
both in rural areas (e.g., central Alabama, southwest Texas, northwest
Arizona) and urban areas (e.g., New York City, Philadelphia, Chicago,
Houston, Los Angeles).
Total Charges for Stroke Hospitalizations, 2000
In 2000, a total of $7.04 billion was charged to Medicare for stroke
hospitalizations. The average charge to Medicare for a stroke
hospitalization was $15,818. Among the 3,187 counties examined in this
Atlas, the average charge per stroke hospitalization per county ranged from
$1,162 to $101,118. The frequency distribution indicates that for the
majority of counties, the average charge per stroke hospitalization ranged
from $6,000 to $24,000.
Counties with the highest average charges per stroke hospitalization (i.e.,
those in the top quintile, for which the average charge was $15,484 or
higher) were located in many parts of the United States, including Florida,
California, Arizona, Hawaii, and Alaska. Counties in the top quintile were
located both in rural areas (e.g., central Alabama) and urban areas (e.g.,
New York City, Philadelphia, Chicago, Houston, Los Angeles).
A Note on Methods
Stroke charges were obtained from the 1995 and 2000 Medicare Provider
Analysis and Review (MEDPAR) Part A data sets. Strokes were defined as those
for which the principal diagnosis on the Medicare hospital claim form was
cerebrovascular disease, indicated by codes 430–434 and 436–438 according to
the International Classification of Diseases, 9th Revision, Clinical
Modification (ICD-9-CM). Hospitalizations for which the principal diagnosis
was transient ischemic attacks (ICD-9-CM code 435) were excluded.
For each map, the counties are categorized according to quintile; the
darkest color represents counties with the highest charges, and the lightest
color represents counties with the lowest charges. Counties are categorized
as having “no data” if there were no stroke hospitalizations in 1995 or
2000.
The frequency distribution in the bottom right corner of each map shows the
range of charges observed among counties on the corresponding map. The
vertical dotted lines and the graded color bar along the x-axis illustrate
the quintiles into which counties were divided on the basis of these
charges. For a detailed explanation of the methods, see
Appendix B.
![Map showing total charges for stroke hospitalizations in the U.S. in 1995. Refer to paragraph above titled Total Charges for Stroke Hospitalizations, 1995 for a detailed explanation of the map.](images/Section-6-1995.jpg)
![Map showing total charges for stroke hospitalizations in the U.S. in 2000. Refer to paragraph above titled Total Charges for Stroke Hospitalizations, 2000 for a detailed explanation of the map.](images/Section-6-2000.jpg)
Page last reviewed: April 9, 2008
Page last modified: April 9, 2008
Content source: Division for Heart Disease and Stroke
Prevention,
National Center for Chronic Disease Prevention and
Health Promotion
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