Costs of Hospital Care for Strokes in India: A Scoping Review

Abstract

The incidence of stroke in India is one of the largest worldwide. With this scoping review, we assessed the evidence on the costs of stroke, which is essential to evaluate whether stroke care interventions are cost-effective. We adopted a healthcare sector and broader societal perspective and searched electronic databases for records including stroke cost estimates (up to 2020). Following deduplication and screening of 2,510 records, we extracted the data (converted into 2020 Indian rupees [INR]) and assessed the quality of eight eligible studies. These studies, published between 2011 and 2020, covered the whole of India and specific localities and were: cost-of-illness studies (n = 3); economic evaluations (n = 2); cross-sectional costing study (n = 1); simulated costing study (n = 1); and policy/clinical review (n = 1). Among the extracted estimates, the mean total costs of stroke care per patient for the period up to six months post admission ranged from ₹19,428.86 in a government hospital in Punjab to ₹118,040.15 in a private tertiary care centre in Ludhiana. The median total out-of-pocket (OOP) payments for cardiovascular disease-related expenditures ranged from ₹18,148.88 to ₹68,464.39 across different income groups. Despite methodological limitations, the data from our scoping review will help in designing economic evaluations of stroke care interventions in India. JEL Codes: C18, C80, D61, I15, I19

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

“…Out-of-pocket expense of stroke rehab in these countries further deter patients and instead contribute to increased stress and poor quality of life. 40 Despite poor evidence, the deep-seated belief in traditional medicine results in stroke patients seeking rehab through approaches like acupressure, massage, herbs, Ayurveda, homeopathy, and Islamic medicine, often leading to delayed onset and, in many cases, no usage at all of post-stroke rehab. 41 , 42 …”