The social and economic burden of stroke survivors in Italy: a prospective, incidence-based, multi-centre cost of illness study

Abstract

BackgroundThe aim of this study was to estimate the one-year societal costs due to a stroke event in Italy and to investigate variables associated with costs in different phases following hospital admission.MethodsThe patients were enrolled in 44 hospitals across the country and data on socio-demographic, clinical variables and resource consumption were prospectively surveyed for 411 stroke survivors at admission, discharge and 3, 6 and 12 months post the event. We adopted a micro-costing procedure to identify cost generating components and the attribution of appropriate unit costs for three cost categories: direct healthcare, direct non-healthcare (including informal care costs) and productivity losses. The relation between costs of stroke management and socio-demographic and clinical characteristics as well as disability levels was evaluated in a series of bivariate analyses using non parametric tests (Mann Whitney and Kruskal-Wallis). Multiple linear regression analyses were performed to determine predictors of costs incurred by stroke patients during the acute phase and follow-up of 1 year.ResultsOn average, one-year healthcare and societal costs amounted to €11,747 and € 19,953 per stroke survivor, respectively. The major cost component of societal costs was informal care accounting for € 6,656 (33.4% of total), followed by the initial hospitalisation, (€ 5,573; 27.9% of total), rehabilitation during follow up (€ 4,112; 20.6 %), readmissions (€ 439) and specialist and general practioner visits (€ 326). Mean drug costs per patient over the follow-up period was about € 50 per month. Costs associated to the provision of paid and informal care followed different pattern and were persistent over time (ranging from € 639 to € 597 per month in the first and the second part of the year, respectively). Clinical variables (presence of diabetes mellitus and hemorrhagic stroke) were significant predictors of total healthcare costs while functional outcomes (Barthel Index and Modified Ranking Scale scores) were significantly associated with both healthcare and societal costs at one year.ConclusionsThe significant role of informal care in stroke management and different distribution of costs over time suggest that appropriate planning should look at both incident and prevalent stroke cases to forecast health infrastructure needs and more importantly, to assure that stroke patients have adequate “social” support.

The experience of stroke survivors three months after being discharged home: A phenomenological investigation

“…5 This results in a significant impact on individuals, families and health care costs. 6,7 Returning home after a stroke is a challenging experience for patients who struggle to adapt to their new life conditions because of physical disabilities, stress, depression, cognitive impairment and reduced quality of life. [8][9][10] Although many studies have been conducted on stroke survivors' experiences, few studies have focused on the lived experience of patients when they return home.…”

For en bedre akuttmedisinsk tjeneste i Norge

“…Det er gjort en liknende studie i Italia som konkluderte med at kostnadene til ett års behandling av en slagpasient utgjør om lag 20 000 euro eller om lag 160 000 norske kroner. Dette er på linje med estimatene i den svenske undersøkelsen (Fattore et al, 2012).…”

Varenicline treatment for smoking cessation in high risk patients: a budget impact analysis

“…The annual cost per CVD patient was estimated based on the studies conducted by Fattore et al [22] on stroke and Roggeri et al [23] on myocardial infarction and angina, which report values of € 11,747.0 and € 11,464.0, respectively. An average cost was adopted, weighted on the number of the sampled populations analyzed.…”