Financial Burden of Stroke Reflected in a Pilot Center for the Implementation of Thrombolysis

Abstract

Stroke represents a serious illness and is extremely relevant from the public health point of view, implying important social and economic burdens. Introducing new procedures or therapies that reduce the costs both in the acute phase of the disease and in the long term becomes a priority for health systems worldwide. The present study quantifies and compares the direct costs for ischemic stroke in patients with thrombolysis treatment versus conservative treatment over a 24-month period from the initial diagnosis, in one of the 7 national pilot centres for the implementation of thrombolytic treatment. The significant reduction (p < 0.001) of the hospitalization period, especially of the days in the intensive care unit (ICU) for stroke, resulted in a significant reduction (p < 0.001) of the total average costs in the patients with thrombolysis, both at the first hospitalization and for the subsequent hospitalizations, during the period followed in the study. It was also found that the percentage of patients who were re-hospitalized within the first 24-months after stroke was significantly lower (p < 0.001) among thrombolyzed patients. The present study demonstrates that the quick intervention in cases of stroke is an efficient policy regarding costs, of Romanian Public Health System, Romania being the country with the highest rates of new strokes and deaths due to stroke in Europe.

Cost Assessment of Inpatient Care Episodes of Stroke in Romania

“…Analyzing the readmission phenomenon, our findings are comparable with other study performed in Romania in one hospital (∼11-14%), but for 2 years period (10).…”

“…Despite Romania being among the least costly countries of Europe in terms of inpatient care of stroke patients, our study confirms that the economic burden of treating stroke episodes puts considerable pressure on the scarce resources of the Romanian healthcare system. Our results regarding cost of stroke inpatient episode being EUR 995.57 in 2017 (with low variability in the costs, the frequency of cases with a given total cost can be found in Figure 1) are comparable with another similar Romanian stroke cost measuring study, made in one clinical hospital (10), but are very different from the estimates of the "The Burden of Stroke in Europe" study (3), which is not surprising, given the different cost assessment methods, and the limitations of data availability. Our estimate puts Romania at the bottom of the EU countries' list of healthcare costs of stroke inpatient episodes; there are few countries with costs so low, even though there has been a substantial wage increase in Romania for health workers to decrease the gap between the wages of Romania and Western Europe.…”

“…In 2017 the Romanian patients still had problems with access to intravenous thrombolysis treatment. By the end of 2019 every county had at least one stroke-ready hospital, but the thrombolysis treatment of stroke is still not as prevalent as in other EU countries (10). The annual number of intravenous thrombolysis in 2015-2016 in Romania has been of 10.3, while the average of 42 countries has been of 142 (11).…”

Societal Cost of Ischemic Stroke in Romania: Results from a Retrospective County-Level Study

“…A total of 959,319 stroke-related deaths were observed between 1994–2017, of which over half (54.3%) were women [ 16 ]. Until now, two costs-of-illness studies focusing on in-hospital costs generated by stroke patients admitted in Romanian public hospitals have been published [ 17 , 18 ].…”

Distress in neurocognitive disorders due to Alzheimer's disease and stroke

“…Quality of life is a concept often avoided by researchers because of its subjective experimentation by patients with neurocognitive disorders, researchers prefer to focus on the emotional profile of the caregivers. The studies show that, for a person diagnosed with such a disorder, the caregivers have to make sustainable efforts, both financially and emotionally (1)(2)(3).…”