The economic impact of mental healthcare consumption before and after stroke in a cohort of stroke patients in the Netherlands: a record linkage study

Abstract

BackgroundPost-stroke healthcare consumption is strongly associated with a mental health diagnosis. This study aimed to identify stroke patients who utilised mental healthcare facilities, explored their mental healthcare consumption pre-stroke and post-stroke, and examined possible predictors of costs incurred by mental healthcare consumption post-stroke.MethodsThree databases were integrated, namely the Maastricht University Medical Centre (MUMC) Medical Administration, the Stroke Registry from the Department of Neurology at MUMC, and the Psychiatric Case Registry South-Limburg. Patients from the MUMC who suffered their first-ever stroke between January 1 2000 and December 31 2004 were included and their records were analysed for mental healthcare consumption from 5 years preceding to 5 years following their stroke (1995–2009). Regression analysis was conducted to identify possible predictors of mental healthcare consumption costs.ResultsA total of 1385 patients were included and 357 (25.8%) received services from a mental healthcare facility during the 10-year reference period around their stroke. The costs of mental healthcare usage increased over time and peaked 1 year post-stroke (€7057; 22% of total mental healthcare costs). The number of hospitalisation days and mental healthcare consumption pre-stroke were significant predictors of mental healthcare costs. Explained variances of these models (costs during the 5 years post-stroke: R 2 = 15.5%, costs across a 10 year reference period: R 2 = 4.6%,) were low.ConclusionStroke patients have a significant level of mental healthcare comorbidity leading to relatively high mental healthcare costs. There is a relationship between stroke and mental healthcare consumption costs, but results concerning the underlying factors responsible for these costs are inconclusive.

Building Wellbeing in People With Chronic Conditions: A Qualitative Evaluation of an 8-Week Positive Psychotherapy Intervention for People Living With an Acquired Brain Injury

“…ABI can be associated with significant and chronic impairments across multiple areas of functioning including physical, cognitive, emotional, behavioral and social domains (Milders et al, 2003;Barman et al, 2016;de Freitas Cardoso et al, 2019;Kane et al, 2019). Critically, the psychological consequences of ABI are generally hidden and are associated with poor involvement in rehabilitation, hospital readmission, long-term disability, limited social activity, reduced ability to manage physical conditions, increased health service usage, suicide and a general increase in risk for mortality (Gillen et al, 2001;Naylor et al, 2012;Ayerbe et al, 2013;van Eeden et al, 2016). People affected by ABI -as with other chronic conditions -have little access to psycho-social interventions to address ongoing holistic needs: almost three-quarters of people living with ABI feel that their psychological needs are not met (McKevitt et al, 2011;Oyesanya, 2017).…”

Brief group‐based acceptance and commitment therapy for stroke survivors

“…The Stroke Association () found that 73% of stroke survivors lacked confidence, 56% felt people treated them differently, and 55% felt unable to care for their families as before. Stroke‐related comorbidities are associated with reduced quality of life (Bays, ; Godwin, Ostwald, Cron, & Wasserman, ; Sturm et al ., ), increased mortality (Ayerbe et al ., ), increased health care utilization (Appleby, Thompson, & Galea, ; Ghose, Williams, & Swindle, ; van Eeden et al ., ), and reduced functional recovery (Gillen, Tennen, McKee, & Gernert‐Dott, ).…”

A study of optimal concentration range and time window of sevoflurane preconditioning for brain protection in MCAO rats

“…Stroke is the leading cause of disability [1] and is a major cause of morbidity [2], leading to high economic burden worldwide. About 30% patients die directly due to the disease each year, and similar percentage of sufferers are functionally disabled [2,3].…”