Introduction: The role of gender and age is well documented with disparities noted in Duration of hospitalization, total Cost of hospitalization and Outcome in stroke patients. The military healthcare system database was reviewed to determine if marital status was risk factor for any of these three criteria.
Hypothesis: We hypothesize that being unmarried would be correlated with an increase in Duration of hospitalization and total Cost of the hospitalization.
Methods: Data was collected from the Defense Health Agency Military Mart (M2) database from fiscal year 2010 to 2016. The M2 database stores data including age, gender and marital status. Adult patients with a primary diagnosis of stroke at discharge (International Classification of Diseases, 9th Revision codes 434.91, 434.11 or 10th Revision code I63.9) were reviewed. Age, Gender and Marital Status were compared for Duration of hospitalization, total Cost of hospitalization and Outcome using Multivariable Analysis.
Results: A total of 3,910 patients discharged from Military hospitals were identified. The Marital status of this sample was: Married 67.1%, Widowed 12.4%, Single 4.7%, Legally Separated 0.5%, and Unknown/Not Reported 4.7%. There was a significant correlation between Marital Status and Duration of hospitalization (average of 1.2 fewer hospital days/patient, P-value <0.01) and total Cost of hospitalization ($1,088 less/patient even after controlling for the shorter hospital stay (P-value <0.05). There was no significant correlation for Marital Status with Outcome. There was a significant correlation between age and increased Duration of hospitalization and worse Outcome. There was no correlation of age with total Cost of hospitalization when we controlled for duration of hospitalizing. There was no correlation for gender with for Duration of hospitalization or total Cost of hospitalization. There was a small, statistically significant correlation of female gender and worse Outcomes (p-value < 0.02).
Conclusions: Unmarried status is an independent risk factor for increased Duration of hospitalization and total Cost of hospitalization. Older age is a risk factor for increased Duration of hospitalization and worse Outcome. Female gender is a risk factor for worse Outcomes.