International Comparison of Stroke Cost Studies

Abstract

Purpose-With the rapid international spread of interventions, there is a need to understand the economic implications of these changes and to interpret these economic implications on the international level. The purpose of this study is to systematically compare total health care expenditures on stroke, the costs of stroke per capita, and the distribution of stroke costs within different countries, with special attention to the allocation of resources among different health care facilities. Methods-Studies for this literature review were selected by conducting a literature search from January 1966 to July 2003. Key methodological, country-related, and monetary issues of the selected stroke cost studies were evaluated using a checklist. Results-After selection, 25 stroke cost studies were reviewed. Although the selected cost of illness studies used different methodologies, the estimated expenditures for stroke are approximately similar. The proportion of national health care in the 8 countries studied is unequivocal for the more recent studies, ie, Ϸ3% of total health care expenditures. A shift is observed from the inpatient treatment costs (in the first year) toward outpatient treatment and long-term care costs (in the latter years). Furthermore, it is remarkable that in the studies, little attention is paid to costs borne by the patient and family or to the costs of comorbidity. Key Words: cost and cost analysis Ⅲ internationality Ⅲ health resources S troke is a major disease in both medical and economic terms. The prevailing emphasis on cost containment and managed care has led to increased interest in the economic aspects of stroke. A total overview of the economic aspects of stroke is given in cost of illness (COI) studies. Results of these COI studies can be used for resource allocation purposes. Over the years, there has been a marked increase in the number of these publications on the economic aspects of stroke. [1][2][3] With the rapid international spread of new diagnostic interventions and care arrangements for stroke, there is a need to understand the economic implications of these changes and to interpret these economic implications on the international level. This article aims to systematically compare how the costs of stroke in different countries are affected by cross-national differences by using a quality checklist. No complete systematic international review of the quality of COI studies in stroke has been undertaken in the literature, although efforts 2-4 have been made to illustrate the economic implication of stroke. The following study is a further elaboration of these earlier reviews. The purpose of this study is to present an international comparison of the total health care expenditures on stroke, the costs of stroke per capita, and the distribution of stroke costs within different countries, with special attention to the allocation of resources among different health care facilities. Conclusions-This

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“…Bei der Auswertung dieser Studien muss berücksichtigt werden, dass deren Qualität sehr eng mit den einbezogenen Daten und der Studienmethodik zusammenhängt. Ein Vergleich zwischen den Studien ist oftmals schwierig, da u. a. unterschiedliche Zeitperioden und Kostenkomponenten betrachtet werden (Evers et al 2004 (Kobelt et al 2006;Reese et al 2011). Sie variieren jedoch in Abhängigkeit von der Verlaufsform, dem Behinderungsgrad und der Schubaktivität (Karampampa et al 2012b;Kobelt et al 2006;Reese et al 2011 (Kobelt et al 2006;Reese et al 2011).…”