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Published on: January 18, 2018
Resource utilization and costs for treatment of stroke patients in an acute stroke unit in Greece
Persefoni Kritikou1, Konstantinos Spengos2, Nikolaos Zakopoulos1
1University of Athens, Department of Clinical Therapeutics, Acute Stroke Unit, Greece.
Insights
The acute treatment of stroke patients in an Acute Stroke Unit (ASU) in Greece incurs significant costs, with neurological impairment and delayed discharge being key cost predictors. Understanding these expenses is crucial for healthcare resource allocation.
Area of Science:
- Healthcare Economics
- Neurology
- Public Health
Background:
- Stroke is the leading cause of death in Greece.
- Acute phase hospitalization accounts for over 40% of stroke care costs.
- There is a need to assess resource utilization and treatment costs in Acute Stroke Units (ASUs).
Purpose of the Study:
- To evaluate resource utilization and estimate treatment costs for stroke patients admitted to an ASU.
- To identify factors influencing the cost of acute stroke care.
Main Methods:
- Analysis of first-ever stroke patients treated in an Athens academic hospital's ASU (2003-2009).
- Assessment of neurological impairment (NIHSS) and handicap (mRS).
- Cost analysis included investigations, medications, staff, and overheads; generalized linear models predicted costs.
Main Results:
- 784 patients analyzed; mean age 72.2 years, mean hospital stay 12.3 days.
- Mean cost per patient was €2,864; mean cost per day was €244.
- Neurological impairment (NIHSS) and delayed discharge significantly predicted higher patient costs (€4,136 for severely handicapped vs. €1,573 for mildly handicapped).
Conclusions:
- ASU treatment costs for stroke patients represent a substantial economic burden in Greece.
- Neurological impairment on admission and delayed discharge are significant cost drivers.
- Further nationwide research is needed to explore long-term stroke treatment costs.
Background:
Stroke comprises the leading cause of death in Greece, and more than 40% of the overall lifetime cost for stroke care, represents the acute phase hospitalization. The aim of the present study was to assess the resource utilization and estimate the costs for treatment of stroke patients in an Acute Stroke Unit (ASU).
Methods:
Patients with first-ever stroke treated in the ASU of an academic hospital in Athens during 2003-2009 were included in the analysis. The National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) were employed to assess the neurological impairment on admission and the handicap at discharge, respectively. The cost categories measured were: diagnostic investigations, medications, medical and nursing staff, and overhead costs. A generalized linear model was used to predict the mean cost per patient, based on the clinical characteristics of the patients on admission, and during their hospitalization.
Results:
In total, 784 patients were included in the analysis, with mean age of 72.2 (11.2) and mean length of hospital stay of 12.3 (9.5) days. The mean cost per patient was estimated at €2,864 (2,198), and the mean cost per day at €244 (54). The relevant cost for the mildly handicapped patients was €1,573 (625), while for the severely handicapped patients it was €4,136 (2,538). Delayed discharge was associated with a mean cost of €362 (634) per patient, while the cost for the acute phase management of the patients was €2,445 (2,471). The neurological impairment on admission (NIHSS score) and the delayed discharge, were strong predictors of the mean cost per patient.
Conclusions:
The costs for treatment of stroke patients in an ASU comprise a significant burden in Greece. Further research should be performed to explore the long-term costs for the treatment of the disease at a nation-wide level.
