ArticleJournal of the American Heart Association2026
County-Level Contributors to Geographic Variation in Medicare Fee-for-Service Stroke Hospitalization Rates: A Cross-Sectional Study.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
7 authors.
Funding
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Abstract
backgroundStroke hospitalization represents underlying stroke incidence and hospital utilization. We sought to identify factors associated with county-level hospitalization rates (HRs) and counties with HRs above or below expectation using publicly available data.
methodsThis cross-sectional study is based on the analysis of county-level 3-year average stroke HRs (principal
resultsThe cohort of 3198 (98.6%) counties and county-equivalents had a mean stroke HR of 11.2 per 100 000 (SD=2.6). The mean characteristics of the included counties were as follows: 19.4% age ≥65 years, 73% White race, 7.6% coronary heart disease prevalence, 38% hyperlipidemia prevalence, and 5.7 primary care physicians per 10 000. In the fully adjusted model, between-county unexplained variation remained moderately high (
conclusionsConsiderable unexplained county-level variance in stroke HRs exists after accounting for a wide variety of known and potential predictors. Future work to clarify the mechanism of known predictors and explain variance may inform interventions to improve systems of care.
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