Direct cost of cerebrovascular disease during the first year of follow-up

Introduction and objective. There are not sufficient studies analyzing the health costs of ictus in Spain. We carried out a prospective study to evaluate the health costs incurred by a person with a stroke during the first postictal year. Patients and methods. We included 118 patients from the Stroke Unit of the Hospital Universitario San Carlos in Madrid, admitted between 1 July and 31 December 1996. We studied 90 survivors, of an average age of 68 years, one year after having an stroke and specifically calculated the cost of an average period in hospital, neuroimaging tests, rehabilitation treatment, medical follow-up in the Outpatient Clinic, transport costs and the cost of medicines. Results. The average cost patient/year was: hospital admission (418,203 ptas.), health transport (108,209 ptas.), cost of medicines (74, 647 ptas.), follow-rep visits (64,496 ptas.), neuroimaging (61,203 ptas.), rehabilitation (58,643 ptas.). The total cost was 79,930, 719 ptas. and the average cost patient/year 888,119 ptas. during the first year following the ictus. The use of health resources depended on the variables: handicap (increased in patients with a score <60 on the Barthel scale), average neurological deficit on the Scandinavian neurological scale and sex (cost greater in women). The clinical follow-up of total infarcts of the territory of the anterior circulation cost twice as much as follow-up in cases of lacunar infarcts. Conclusions. Cerebrovascular disease is expensive in terms of health-care. Fifty four percent of the health-care expenses are incurred during the acute phase of the ictus and the other 46% during the first year of follow-up [REV NEUROL 1999; 28: 1123-30].