The development and use of a method to compare the costs of acute stroke across Europe

Background: there is a need for more information on the costs of different ways of managing stroke. Methods to compare the costs of stroke care in different countries have not been previously developed. Objective: to develop and use a method to compare the costs of acute stroke care across Europe. Setting: acute hospitals in 13 different European centres. Subjects and methods: we included in the study stroke patients hospitalized during 1996-7 at 13 centres across Europe (n=2072). We recorded the duration of acute hospital stay and use of investigations. Mean costs for each centre were predicted using linear regression analysis to adjust for case-mix differences. Results: the average acute hospital stay ranged from 9 days (Spain) to 35 days (UK; P<0.001). The predicted mean cost of treating conscious, continent men aged >74 ranged from $220 (95% confidence interval 191-254) in Latvia to $5164 (4294-6191) in Austria. Conclusions: differences in the acute costs of stroke exist across Europe because of differences in clinical practice and unit costs. This methodology will be used to capture the costs incurred by a broad range of care providers. These estimates will then be suitable for using in cost-effectiveness analysis.