The cost of first-ever stroke in Valle d’Aosta, Italy: linking clinical registries and administrative data

Abstract

BackgroundStroke is one of the most relevant reasons of death and disability worldwide. Many cost of illness studies have been performed to evaluate direct and indirect costs of ischaemic stroke, especially within the first year after the acute episode, using different methodologies.MethodsWe conducted a longitudinal, retrospective, bottom-up cost of illness study, to evaluate clinical and economic outcomes of a cohort of patients affected by a first cerebrovascular event, including subjects with ischaemic, haemorrhagic or transient episodes. The analysis intended to detect direct costs, within 1, 2 and 3 years from the index event. Clinical patient data collected in regional disease registry were integrated and linked to regional administrative databases to perform the analysis.ResultsThe analysis of costs within the first year from the index event included 800 patients. The majority of patients (71.5%) were affected by ischaemic stroke. Overall, per patient costs were €7,079. Overall costs significantly differ according to the type of stroke, with costs for haemorrhagic stroke and ischaemic stroke amounting to €9,044 and €7,289. Hospital costs, including inpatient rehabilitation, were driver of expenditure, accounting for 89.5% of total costs. The multiple regression model showed that sex, level of physical disability and level of neurological deficit predict direct healthcare costs within 1 year. The analysis at 2 and 3 years (per patient costs: €7,901 and €8,874, respectively) showed that majority of costs are concentrated in the first months after the acute event.ConclusionsThis cost analysis highlights the importance to set up significant prevention programs to reduce the economic burden of stroke, which is mostly attributable to hospital and inpatient rehabilitation costs immediately after the acute episode. Although some limitation typical of retrospective analyses the approach of linking clinical and administrative database is a power tool to obtain useful information for healthcare planning.

Direct medical cost of stroke in Singapore

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Analisis Biaya Penyakit Stroke Pasien Jaminan Kesehatan Nasional di RSUD Blambangan Banyuwangi

“…(70,3%-78%) dari subyek penelitian 7,24,25,26 . Adanya beberapa faktor resiko stroke yang tidak dapat dimodifikasi seperti usia, jenis kelamin, ras dan riwayat keluarga serta efek kumulatif penuaan pada sistem kardiovaskular dan serebrovaskular, dan sifat progresif dari faktor resiko stroke selama periode waktu yang lama secara substansial meningkatkan resiko stroke.…”

Prevalence of Multiple Sclerosis in Tuscany (Central Italy): A Study Based on Validated Administrative Data

“…Despite some limitations of our findings and of our method, we have also demonstrated that our algorithm, based on administrative data, can accurately identify patient cohorts. Our future aims are to investigate the geographical distribution of MS in Tuscany and to create an integrated dataset with administrative and clinical data to monitor not only prevalence but also disease-care pathways and proxy to outcomes [36,37,38]. …”