Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Michelle L. Woodbury

Third Advisor

Annie N. Simpson

Fourth Advisor

Amit Shah


This study used a 5% sample of Medicare billing records from 2012 to identify cost differences between posterior circulation (PCS) and anterior circulation strokes (ACS). We examined ICD-9 codes related to these stroke types at hospital admission, records for six months post stroke, or until death, and identified mean payment and charges by type of care received. The Charlson Comorbidity Score was used to control for the effects of comorbid conditions on cost, survival, and the use of tPA during the Index admission. We identified 105 PCS and a comparison group of 5230 subjects with ACS and compared mean Medicare payment data from initial hospital admission, physician hospital payments, inpatient rehabilitation, outpatient rehabilitation, physician office visits, home healthcare, DME, nursing home care, hospital readmissions, and hospice care. As hypothesized, PCS have greater costs than ACS during early recovery from an ischemic stroke.


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