Abstract
BackgroundStroke is one of the most relevant reasons of death and disability worldwide. Many cost of illness studies have been performed to evaluate direct and indirect costs of ischaemic stroke, especially within the first year after the acute episode, using different methodologies.MethodsWe conducted a longitudinal, retrospective, bottom-up cost of illness study, to evaluate clinical and economic outcomes of a cohort of patients affected by a first cerebrovascular event, including subjects with ischaemic, haemorrhagic or transient episodes. The analysis intended to detect direct costs, within 1, 2 and 3 years from the index event. Clinical patient data collected in regional disease registry were integrated and linked to regional administrative databases to perform the analysis.ResultsThe analysis of costs within the first year from the index event included 800 patients. The majority of patients (71.5%) were affected by ischaemic stroke. Overall, per patient costs were €7,079. Overall costs significantly differ according to the type of stroke, with costs for haemorrhagic stroke and ischaemic stroke amounting to €9,044 and €7,289. Hospital costs, including inpatient rehabilitation, were driver of expenditure, accounting for 89.5% of total costs. The multiple regression model showed that sex, level of physical disability and level of neurological deficit predict direct healthcare costs within 1 year. The analysis at 2 and 3 years (per patient costs: €7,901 and €8,874, respectively) showed that majority of costs are concentrated in the first months after the acute event.ConclusionsThis cost analysis highlights the importance to set up significant prevention programs to reduce the economic burden of stroke, which is mostly attributable to hospital and inpatient rehabilitation costs immediately after the acute episode. Although some limitation typical of retrospective analyses the approach of linking clinical and administrative database is a power tool to obtain useful information for healthcare planning.
Highlights
Stroke is one of the most relevant reasons of death and disability worldwide
Owing to the high level of morbidity associated with stroke, the economic burden of this disease is substantial
Study design The present study is a longitudinal, retrospective, bottom-up cost of illness study, aimed to evaluate clinical and economic outcomes of a cohort of patients affected by a first cerebrovascular event
Summary
Stroke is one of the most relevant reasons of death and disability worldwide. The traditional definition of a stroke, [1], is “a neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours”. Stroke is one of the most common causes of death, long-term morbidity and disability [2,3,4]. 15 million people worldwide suffer a stroke [5]. Owing to the high level of morbidity associated with stroke, the economic burden of this disease is substantial. For 2008, it was estimated that stroke would cost the US economy $ 65.5 billion in healthcare services, medications, and lost productivity [7]
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