Real-world costs of ischemic stroke by discharge status
Current Medical Research and Opinion. Feb 2017;33(2):371-378
OBJECTIVE:
The objective of this study was to estimate the acute healthcare costs of ischemic stroke during hospitalization and the quarterly all-cause healthcare costs for the first year after discharge by discharge status.
METHODS:
Adult patients with a hospitalization with a diagnosis of ischemic stroke (ICD-9-CM: 434.xx or 436.xx) between 1 January 2006 and 31 March 2015 were identified from a large US commercial claims database. Patients were classified into three cohorts based on their discharge status from the first stroke hospitalization, i.e. dead at discharge, discharged with disability, or discharged without disability. Third-party (medical and pharmacy) and out-of-pocket costs were adjusted to 2015 USD.
RESULTS:
A total of 7919 patients dead at discharge, 45,695 patients discharged with disability, and 153,778 patients discharged without disability were included in this analysis. The overall average age was 59.7 years and 52.3% were male. During hospitalization, mean total costs (third-party and out-of-pocket) were $68,370 for patients dead at discharge, $73,903 for patients discharged with disability, and $24,448 for patients discharged without disability (p < .001 for each pairwise comparison mean third-partycostswere 63605 for patients dead atdischarge 67861 for patients discharged with disability and 19267 for patients discharged without disability p>< .001 for each pairwise comparison. during the first year afterdischarge mean totalcostsfor patients discharged with disability vs. without disability were 46850 vs. 30132 p>< .001). mean third-partycostsfor patients discharged with disability vs. without disability were 19116 vs. 10976 during the first quarter afterdischarge 10236 vs. 6926 during the second quarter 8241 vs. 5810 during the third quarter and 6875 vs. 5292 during the fourth quarter p>< .001 for each quarter.>
CONCLUSION:
The results demonstrated the high economic burden of ischemic stroke, especially among patients discharged with disability with the highest costs incurred during the inpatient stays.