Younger stroke survivors (45 to 64 years old) have a disproportionately harder time accessing proper post-stroke medical care than do older stroke survivors (65 and above) in the United States.
That’s the finding of a study to be published in the January issue of Archives of Neurology led by Deborah A. Levine, M.D., M.P.H., assistant professor of medicine at the University of Alabama at Birmingham (UAB).
The more than five million stroke survivors often require treatment to reduce risk factors such as high blood pressure, high cholesterol and diabetes that could lead to future strokes and heart complications. Treatment of these medical conditions usually requires medications and follow-up doctor visits.
“Patients with stroke who do not have adequate access to physician care and medications may not receive appropriate treatment of their risk factors,” said Levine, who practices at the Birmingham Veterans Affairs Medical Center. “Consequently, they may have an increased risk of additional cardiovascular events such as stroke or heart attack.”
Levine and colleagues used the annual National Health Interview Survey between 1998 and 2002 to assess the responses of nearly 3,700 stroke survivors above the age of 45. Compared to the older stroke survivors, younger survivors were less likely to have health insurance, visit a general physician or medical specialist or be able to afford prescriptions.
Results of the study suggest that younger stroke survivors have less access to physician care than older stroke survivors, largely due to lack of health insurance. However, in this report, lack of health insurance does not fully explain why younger stroke survivors had more difficulty affording medications than older stroke survivors, according to Levine. Competing household costs or a lack of prescription drug coverage are possible explanations, although neither could be assessed directly in the study.
“Providing affordable health insurance or, more radically, immediate Medicare insurance to uninsured stroke survivors would be expected to improve access to care. Affordable prescription drug coverage is needed to improve access to medications,” Levine said.
In addition to Levine, study authors are Catarina I. Kiefe, Ph.D., M.D., Thomas K. Houston, M.D., M.P.H., and Jeroan J. Allison, M.D., M.Sc., all of UAB; Ellen P. McCarthy, Ph.D., of Beth Israel Deaconess Medical Center; and John Z. Ayanian, M.D., M.P.P., of Brigham and Women’s Hospital and Harvard Medical School.
The study appears online at http://archneur.ama-assn.org/.