TY - JOUR
T1 - Initial and subsequent 3-year cost after hospitalization for first acute ischemic stroke and intracerebral hemorrhage
AU - Yousufuddin, Mohammed
AU - Moriarty, James P.
AU - Lackore, Kandace A.
AU - Zhu, Ye
AU - Peters, Jessica L.
AU - Doyle, Taylor
AU - Jensen, Kelsey L.
AU - Ahmmad, Eimad M.
AU - Al Ward, Ruaa Y.
AU - Al-Zu'bi, Hossam M.
AU - Sharma, Umesh M.
AU - Seshadri, Ashok
AU - Arumaithurai, Kogulavadanan
AU - Keenan, Lawrence R.
AU - Bhagra, Sumit
AU - Murad, Mohammad Hassan
AU - Borah, Bijan J.
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/12/15
Y1 - 2020/12/15
N2 - Aims: To examine 1) the major drivers of index hospitalization and 3-year post-acute follow-up care, 2) cost for rehabilitation and homecare, and 3) indirect cost from lost productivity after acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). Methods: Retrospective study of adults hospitalized with AIS (n = 811) and ICH (N = 145) between 2003 and 2014. Direct costs standardized to Medicare reimbursement rates were captured for hospitalization and 3-year follow-up or death. Adjusted cost estimates were assessed using generalized linear modeling with gamma distribution. Costs for rehabilitation, home healthcare, and lost productivity were assessed using sets of cost captured through literature review. Results: Calculated as mean cost per person: hospitalization $18,154 for AIS and $24,077 for ICH; monthly 3-year aggregate $5138 for AIS and $8172 for ICH; 3-year inpatient rehabilitation $4185 for AIS and $4196 for ICH; homecare $19,728 for AIS and $14,487 for ICH; indirect cost from lost productivity $77,078 for AIS and $56,601 for ICH. Age < 55 years, being non-white, and stroke severity were strongly associated with greater hospitalization cost for AIS and ICH. Hyperlipidemia incurred lower while cancer, coronary artery disease, asthma/chronic obstructive pulmonary disease, heart failure, and anemia incurred higher 3-year aggregate cost for AIS. Cancer and diabetes mellitus incurred higher 3-year aggregate cost for ICH. Conclusions: We provide estimates of direct and indirect costs incurred for acute and continuing post-acute care through a 3-year follow-up period after first-ever AIS and ICH with important comparisons for predictors between index hospitalization and 3-year post-stroke costs.
AB - Aims: To examine 1) the major drivers of index hospitalization and 3-year post-acute follow-up care, 2) cost for rehabilitation and homecare, and 3) indirect cost from lost productivity after acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). Methods: Retrospective study of adults hospitalized with AIS (n = 811) and ICH (N = 145) between 2003 and 2014. Direct costs standardized to Medicare reimbursement rates were captured for hospitalization and 3-year follow-up or death. Adjusted cost estimates were assessed using generalized linear modeling with gamma distribution. Costs for rehabilitation, home healthcare, and lost productivity were assessed using sets of cost captured through literature review. Results: Calculated as mean cost per person: hospitalization $18,154 for AIS and $24,077 for ICH; monthly 3-year aggregate $5138 for AIS and $8172 for ICH; 3-year inpatient rehabilitation $4185 for AIS and $4196 for ICH; homecare $19,728 for AIS and $14,487 for ICH; indirect cost from lost productivity $77,078 for AIS and $56,601 for ICH. Age < 55 years, being non-white, and stroke severity were strongly associated with greater hospitalization cost for AIS and ICH. Hyperlipidemia incurred lower while cancer, coronary artery disease, asthma/chronic obstructive pulmonary disease, heart failure, and anemia incurred higher 3-year aggregate cost for AIS. Cancer and diabetes mellitus incurred higher 3-year aggregate cost for ICH. Conclusions: We provide estimates of direct and indirect costs incurred for acute and continuing post-acute care through a 3-year follow-up period after first-ever AIS and ICH with important comparisons for predictors between index hospitalization and 3-year post-stroke costs.
KW - Healthcare cost
KW - Intracerebral hemorrhage
KW - Ischemic stroke
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U2 - 10.1016/j.jns.2020.117181
DO - 10.1016/j.jns.2020.117181
M3 - Article
C2 - 33099173
AN - SCOPUS:85093670993
SN - 0022-510X
VL - 419
JO - Journal of the neurological sciences
JF - Journal of the neurological sciences
M1 - 117181
ER -