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Relationship between functional disability and costs one and two years post stroke

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)).

Method: Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS).

Results: The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability.

Conclusion: Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke.

No MeSH data available.


Distribution over mRS categories and missing mRS assessment during first and second year, respectively.
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pone.0174861.g001: Distribution over mRS categories and missing mRS assessment during first and second year, respectively.

Mentions: The survival rates at one and two years post stroke were lower for patients with ICH (61% and 56% respectively) compared to patients with IS (77% and 69% respectively) (Fig 1). The division by mRS categories indicate that a higher proportion of patients with IS had a better health outcome (i.e. mRS 0–2) at the first-year assessment (based on mRS at three months), but the proportion decreased by the second-year assessment (based on mRS at twelve months), irrespective of stroke type. However, for second-year assessment, there was a high proportion of patients with missing data on mRS. For this reason, the results of resource use for all surviving patients were also presented.


Relationship between functional disability and costs one and two years post stroke
Distribution over mRS categories and missing mRS assessment during first and second year, respectively.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383241&req=5

pone.0174861.g001: Distribution over mRS categories and missing mRS assessment during first and second year, respectively.
Mentions: The survival rates at one and two years post stroke were lower for patients with ICH (61% and 56% respectively) compared to patients with IS (77% and 69% respectively) (Fig 1). The division by mRS categories indicate that a higher proportion of patients with IS had a better health outcome (i.e. mRS 0–2) at the first-year assessment (based on mRS at three months), but the proportion decreased by the second-year assessment (based on mRS at twelve months), irrespective of stroke type. However, for second-year assessment, there was a high proportion of patients with missing data on mRS. For this reason, the results of resource use for all surviving patients were also presented.

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)).

Method: Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS).

Results: The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability.

Conclusion: Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke.

No MeSH data available.