In-Patient Hospital Costs of Stroke: A Focused Literature Review

Abstract

N= 4,350) were followed for one year using hospital Discharge Abstract Database. The severity of the stroke was obtained from the ambulatory care database. Median hospital costs by CMG+ group were obtained from Alberta Health. Hospitals were classified as teaching, community large, community medium, and community small hospitals. Hospitals were also classified as comprehensive stroke centre, urban and rural primary stroke centres, and other urban and rural hospitals. The adjusted risk factors in Bayesian Model included sex, age, all disease-specific co-morbidities, and disease severity. The results for four hospital types and five stroke center categories were calculated using the observed/expected approach. Results: The 30 days mortality rates (95% CI) were lowest for teaching hospitals 10.1% (9.0%-11.2%) and large community hospitals (10.0%; 8.3%-11.8%), and the small community hospitals had the highest mortality rates (12.8%; 9.9%-15.8%). The mean LOS (95% CI) varied from 21.7 (20.9-22.6) days in teaching hospitals to 34.2 (28.6-41.0) days in community medium hospitals. The community medium hospitals had significantly higher costs ($62,400; $49,900-$78,000) than the community large hospitals ($32,900; $29,900-$36,200) and teaching hospitals ($37,000; $34,900-$39,200). Both comprehensive stroke and urban stroke centers had lower 30 day mortality rates (95% CI): 9.9% (8.8%-11.1%) and 9.7% (7.3%-12.0%); shorter LOS 21.6 (20.7-22.5) and 25.0 (22.7-27.6) days; and medium levels of costs $39,300 ($36,100-$40,700), compared to other hospitals. ConClusions: The study shows the hospital type and stroke centre had limited effects on the mortality but significant impact on LOS and costs.objeCtives: This study examines the association of 30 day in-hospital mortality, length of stay (LOS) during the first hospital episode, and hospitalization costs during one year after acute ischemic stroke by type of hospital and by stroke centre

The costs associated with stroke care continuum: a systematic review

“…Given that the published data confirmed that thrombectomy-treated patients were significantly more likely to be functionally independent than those receiving standard care, early critical care has become a keystone of acute ischemic stroke therapy, but also accounted for nearly one-third of the total expenditure [ 58 , 67 – 71 ]. The costs of selection for Endovascular thrombectomy (EVT) have rarely been studied [ 69 , 70 ] beyond interventions representing costs made in consecutive years post-stroke. Every 10 min of earlier treatment by pre-hospital triage and in-hospital workflow to endovascular thrombectomy may be €11,968.93 (€6,9589.47–18,027.94) of net monetary benefits for taking health care and societal perspectives over a disability-free life [ 72 ] .…”

The effects of respiratory muscle training on respiratory function and functional capacity in patients with early stroke: a meta-analysis

“…Stroke has become a major global health problem due to its high incidence, high disability rate, high recurrence rate, high mortality rate and high cost [ 1 – 3 ]. With the improvement of medical management for early stroke, most early stroke patients can survive but face loss of function [ 3 – 5 ].…”