Costs during the first year after stroke by degree of functional disability: A societal perspective.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-11-30 DOI:10.1177/23969873241301904

Mercè Soler-Font, Aida Ribera, Ignacio Aznar-Lou, Alba Sánchez-Viñas, John Slof, Emili Vela, Mercè Salvat-Plana, Lorena Villa-García, Antoni Serrano-Blanco, Natàlia Pérez de la Osa, Marc Ribó, Sònia Abilleira

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引用次数: 0

Abstract

Introduction: The aim of this study was to estimate societal costs during the first year after stroke by degree of functional disability.

Patients and methods: Descriptive study of the cumulative costs incurred during 1-year follow-up of a cohort of patients with stroke in Catalonia (Spain) participating in a multicentre, population-based, cluster-randomised trial (RACECAT). Patients were recruited between September 2017 and January 2019. Costs were collected for each patient from stroke onset to 1-year follow-up through hospital accounting records, electronic healthcare records and structured telephone-based interviews at 6 and 12-months follow-up. Disability was assessed using the 90-day modified Rankin Scale (mRS). Healthcare, community care, and patient/family costs were included. We used complete data from 567 eligible participants. Cost data were analysed using generalised linear models (GLMs) with gamma distributions and log link functions. For variables with >10% zero values, two-part models were applied. We performed sensitivity analyses modifying unit costs for patient/family costs.

Results: Of the 567 patients included, 53% had ischaemic large vessel oclusion (LVO) stroke, 24% intracranial haemorrhage and 23% ischaemic non-LVO stroke. Mean cost per patient during the first year after stroke was €29,673 ± 28,632, and increased with degree of disability (mRS 0-2: €18,568 ± 12,244; mRS 3: €38,214 ± 28,172; mRS 4-5: €52,859 ± 36,383). Healthcare costs represented the highest proportion of total costs (63%; €18,724/patient) across all disability levels, with index hospitalisation being the highest (€12,319 ± 17,675); however, community care and patient/family costs represented over 40% of total cost in patients with higher disability levels.

Discussion and conclusion: Our results are in line with other studies; the costs during the first year after stroke are high and increase with disability. These results are valuable for calculating the cost of severe stroke cases.

查看原文本刊更多论文

按功能残疾程度划分的中风后第一年的费用：一个社会视角。

本研究的目的是通过功能残疾程度来估计中风后第一年的社会成本。患者和方法：在加泰罗尼亚（西班牙）参加一项多中心、基于人群的集群随机试验（RACECAT）的卒中患者队列1年随访期间发生的累积成本的描述性研究。患者是在2017年9月至2019年1月期间招募的。通过医院会计记录、电子医疗记录和随访6个月和12个月的结构化电话访谈，收集每位患者从中风发作到随访1年的费用。使用90天改良Rankin量表（mRS）评估残疾。其中包括医疗保健、社区护理和患者/家庭费用。我们使用了567名符合条件的参与者的完整数据。成本数据分析使用广义线性模型（GLMs）与伽马分布和日志链接函数。对于>10%为零的变量，采用两部分模型。我们进行了敏感性分析，修改了患者/家庭成本的单位成本。结果：567例患者中，53%发生缺血性大血管闭塞（LVO）卒中，24%发生颅内出血，23%发生缺血性非LVO卒中。卒中后第一年每位患者的平均费用为29,673±28,632欧元，随着残疾程度的增加而增加(mRS 0-2: 18,568±12,244欧元；mRS 3: 38214±28172欧元；夫人4-5：€52,859±36,383)。医疗保健费用占总费用的比例最高(63%；在所有残疾级别中，18,724欧元/患者)，住院指数最高（12,319±17,675欧元）；然而，社区护理和患者/家庭费用占残疾程度较高的患者总费用的40%以上。讨论与结论：我们的结果与其他研究一致；中风后第一年的费用很高，并且随着残疾而增加。这些结果对计算严重中风病例的费用有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.