Lifetime cost of stroke subtypes in Australia findings from the North East Melbourne Stroke Incidence Study (NEMESIS)

被引:72
作者
Dewey, HM
Thrift, AG
Mihalopoulos, C
Carter, R
Macdonell, RAL
McNeil, JJ
Donnan, GA
机构
[1] Austin & Repatriat Med Ctr, Natl Stroke Res Inst, Heidelberg, Vic, Australia
[2] Austin & Repatriat Med Ctr, Dept Neurol, Heidelberg, Vic, Australia
[3] Univ Melbourne, Dept Med, Melbourne, Vic, Australia
[4] Alfred Hosp, Monash Med Sch, Dept Epidemiol & Prevent Med, Prahran, Vic 3181, Australia
[5] Univ Melbourne, Dept Publ Hlth, Ctr Hlth Program Evaluat, Heidelberg Hts, Australia
关键词
Australia; costs and cost analysis; incidence; stroke; stroke classification;
D O I
10.1161/01.STR.0000091395.85357.09
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Little is known about any variations in resource use and costs of care between stroke subtypes, especially nonhospital costs. The purpose of this study was to describe the patterns of resource use and to estimate the first-year and lifetime costs for stroke subtypes. Methods-A cost-of-illness model was used to estimate the total first-year costs and lifetime costs of stroke subtypes for all strokes (subarachnoid hemorrhages excluded) that occurred in Australia during 1997. For each subtype, average cost per case during the first year and the present value of average cost per case over a lifetime were calculated. Resource use data obtained in the North East Melbourne Stroke Incidence Study (NEMESIS) were used. Results-The present value of total lifetime costs for all strokes was Aus $1.3 billion (US $985 million). Total lifetime costs were greatest for ischemic stroke (72%; Aus $936.8 million; US $709.7 million), followed by intracerebral hemorrhage (26%; Aus $334.5 million; US $253.4 million) and unclassified stroke (2%; Aus $30 million; US $22.7 million). The average cost per case during the first year was greatest for total anterior circulation infarction (Aus $28 266). Over a lifetime, the present value of average costs was greatest for intracerebral hemorrhage (Aus $73 542), followed by total anterior circulation infarction (Aus $53 020), partial anterior circulation infarction (Aus $50 692), posterior circulation infarction (Aus $37 270), lacunar infarction (Aus $34 470), and unclassified stroke (Aus $12 031). Conclusions-First-year and lifetime costs vary considerably between stroke subtypes. Variation in average length of total hospital stay is the main explanation for differences in first-year costs.
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收藏
页码:2502 / 2507
页数:6
相关论文
共 22 条
[1]   CLASSIFICATION AND NATURAL-HISTORY OF CLINICALLY IDENTIFIABLE SUBTYPES OF CEREBRAL INFARCTION [J].
BAMFORD, J ;
SANDERCOCK, P ;
DENNIS, M ;
BURN, J ;
WARLOW, C .
LANCET, 1991, 337 (8756) :1521-1526
[2]   COSTS OF MEDICAL-CARE AFTER FIRST-EVER STROKE IN THE NETHERLANDS [J].
BERGMAN, L ;
VANDERMEULEN, JHP ;
LIMBURG, M ;
HABBEMA, JDF .
STROKE, 1995, 26 (10) :1830-1836
[3]   LONG-TERM SURVIVAL AFTER 1ST-EVER STROKE - THE OXFORDSHIRE COMMUNITY STROKE PROJECT [J].
DENNIS, MS ;
BURN, JPS ;
SANDERCOCK, PAG ;
BAMFORD, JM ;
WADE, DT ;
WARLOW, CP .
STROKE, 1993, 24 (06) :796-800
[4]   Incidence and outcome of subtypes of ischaemic stroke: Initial results from the North East Melbourne Stroke Incidence Study (NEMESIS) [J].
Dewey, HM ;
Sturm, J ;
Donnan, GA ;
Macdonell, RAL ;
McNeil, JJ ;
Thrift, AG .
CEREBROVASCULAR DISEASES, 2003, 15 (1-2) :133-139
[5]   Informal care for stroke survivors - Results from the North East Melbourne Stroke Incidence Study (NEMESIS) [J].
Dewey, HM ;
Thrift, AG ;
Mihalopoulos, C ;
Carter, R ;
Macdonell, RAL ;
McNeil, JJ ;
Donnan, GA .
STROKE, 2002, 33 (04) :1028-1033
[6]   Cost of stroke in Australia from a societal perspective - Results from the North East Melbourne Stroke Incidence Study (NEMESIS) [J].
Dewey, HM ;
Thrift, AG ;
Mihalopoulos, C ;
Carter, R ;
Macdonell, RAL ;
McNeil, JJ ;
Donnan, GA .
STROKE, 2001, 32 (10) :2409-2416
[7]  
DEWEY HM, 2003, IN PRESS J CLIN NEUR
[8]  
Eagar K., 1997, AUSTR NATL SUBACUTE
[9]   CONFIDENCE-INTERVALS RATHER THAN P-VALUES - ESTIMATION RATHER THAN HYPOTHESIS-TESTING [J].
GARDNER, MJ ;
ALTMAN, DG .
BMJ-BRITISH MEDICAL JOURNAL, 1986, 292 (6522) :746-750
[10]   THE INCIDENCE AND ECONOMIC COSTS OF CANCER, MOTOR-VEHICLE INJURIES, CORONARY HEART-DISEASE, AND STROKE - A COMPARATIVE ANALYSIS [J].
HARTUNIAN, NS ;
SMART, CN ;
THOMPSON, MS .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1980, 70 (12) :1249-1260