Abstract
Background:Stroke and dementia are frequent comorbidities. Dementia possibly increases total costs of stroke care, especially cost of institutionalization and informal medical care. However, stroke rehabilitation costs in dementia patients are understudied.Objective:To estimate inpatient stroke rehabilitation costs for Swedish dementia patients in comparison with non-dementia patients.Methods:A longitudinal cohort study with linked data from the Swedish Dementia Register and the Swedish Stroke Register was conducted. Patients diagnosed with dementia who suffered a first ischemic stroke between 2010 and 2014 (n = 138) were compared with non-dementia patients (n = 935). Cost analyses were conducted from a Swedish health care perspective. The difference of rehabilitation costs between the two groups was examined via simple linear regression (before and after matching by propensity scores of dementia) and multiple linear regression.Results:Mean inpatient rehabilitation costs for dementia and non-dementia patients were SEK 103,693/$11,932 and SEK 130,057/$14,966, respectively (median SEK 92,183/$10,607 and SEK 106,365/$12,239) (p = 0.001). Dementia patients suffered from more comorbidities and experienced lower functioning, compared to non-dementia patients. The inpatient rehabilitation cost for patients with known dementia was 0.84 times the cost in non-dementia individuals.Conclusion:Dementia diagnosis was significantly associated with lower inpatient stroke rehabilitation costs. This might be explained by physicians’ beliefs on the limited effectiveness of rehabilitation in dementia patients. Further research on cost-effectiveness of stroke rehabilitation and patients’ satisfaction with stroke rehabilitation is necessary.
Highlights
Stroke and dementia are frequently comorbid conditions
Stroke rehabilitation is essential for recovery, in individuals with dementia as they have a higher rate of disability and mortality [5]
The level of independence with clothing, mobility, and toileting before stroke was lower in dementia patients compared with non-dementia controls (p = 0.001)
Summary
Stroke and dementia are frequently comorbid conditions. These two diseases are among the most common causes of death and disability in Sweden [1, 2]. The societal costs of dementia in Sweden were estimated at SEK 62.9 billion (about $7.2 billion) [4]. The county councils administer specialized care (providing acute care, inpatient rehabilitation and outpatient rehabilitation for stroke patients at hospitals) and primary care (supplying primary, secondary prevention and long-term rehabilitation at primary care centers) [8, 9]. The municipalities take charge of home help services, special accommodation and share the responsibility for long-term rehabilitation with county councils in several regions [8, 9]. Objective: To estimate inpatient stroke rehabilitation costs for Swedish dementia patients in comparison with non-dementia patients. Dementia patients suffered from more comorbidities and experienced lower functioning, compared to non-dementia patients. The inpatient rehabilitation cost for patients with known dementia was 0.84 times the cost in non-dementia individuals
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
