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MENTAL HEALTH STATUS AND ITS ASSOCIATION WITH HEALTHCARE EXPENDITURE AMONG US STROKE PATIENTS: 2011-2018
Background and Aims
Poor mental health is commonly reported among stroke patients. The purpose of this study was 1) to determine mental health status and identify predictors of poor mental health, and 2) to examine differences in healthcare expenditures by mental health status among stroke patients.
We conducted a retrospective cross-sectional analysis using the 2011-2018 Medical Expenditure Panel Survey, a nationally representative survey of non-institutionalized US adults. Diagnosis of stroke and perceived mental health status were self-reported. Healthcare expenditures were direct medical costs calculated as the sum of payments to providers. Individual sociodemographic characteristics and comorbidities were included as covariates. Descriptive statistics were used to describe mental health status of stroke patients. A survey design-adjusted logistic regression was used to identify predictors of poor mental health. Healthcare expenditures were compared using the Mann-Whitney U test.
A total of 7,215 stroke patients (equating to 70,226,052 stroke patients nationwide) were identified, of which 533 (7.0%) reported poor mental health. Poverty was a strong predictor of poor mental health (p=0.013). The median annual health expenditure for stroke patients was $7,822 (2018 USD). Patients who reported poor mental health spent $12,884 annually, significantly higher than their counterparts did ($7,599, p<0.0001).
Our findings suggest that poverty is a strong predictor of mental health status among US stroke survivors. Stroke patients with poor mental health have higher healthcare expenditures; therefore, interventions for promoting mental health are needed for this population.