Cost of acute stroke. A review

The annual incidence of cerebrovascular diseases in Belgium is between 200 and 230/100,000 inhabitants. Mortality after stroke is about 21% and approximately 30% of stroke patients will be dependent on others. Cost is mainly related to the length of hospital stay but also to outpatient care. Length of stay is dependent on stroke severity at entry, stroke location (total infarct in the anterior circulation costs twice as much as small lacunar infarcts), and the social status (patients living alone or in a nursing home have a longer length of stay gene-rating a higher cost). Stroke units by using rationalized acute stroke therapy (including thrombolysis) reduce death and disability and decrease the length of stay by acting on stroke severity and co-morbidities. Stroke units also facilitate early discharge by coordinating outpatient care with the general practitioners, rehab centers, and nursing home. A global stroke-based prospective payment should be implemented in Belgium.