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Updated: Mar 12, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Real-world costs of ischemic stroke by discharge status
Insights
Ischemic stroke incurs substantial healthcare costs, particularly for patients discharged with disabilities. Costs during hospitalization were highest for those who died or had disabilities.
Area of Science:
- Health Economics
- Neurology
- Public Health
Background:
- Ischemic stroke represents a significant public health concern with substantial economic implications.
- Understanding the acute and post-discharge healthcare costs associated with ischemic stroke is crucial for resource allocation and patient management.
Purpose of the Study:
- To estimate the acute healthcare costs during hospitalization for ischemic stroke.
- To determine the all-cause healthcare costs in the first year post-discharge, stratified by discharge status (death, disability, no disability).
Main Methods:
- Analysis of a large US commercial claims database for adult patients hospitalized with ischemic stroke (ICD-9-CM: 434.xx or 436.xx) between 2006 and 2015.
- Classification of patients into three cohorts based on discharge status: deceased, discharged with disability, or discharged without disability.
- Adjustment of third-party (medical, pharmacy) and out-of-pocket costs to 2015 USD for accurate financial assessment.
Main Results:
- Inpatient costs were highest for patients who died at discharge ($68,370) and those discharged with disability ($73,903) compared to those without disability ($24,448).
- First-year post-discharge costs were significantly higher for patients discharged with disability ($46,850) versus without disability ($30,132).
- Quarterly costs in the first year post-discharge remained elevated for patients with disabilities, indicating ongoing economic burden.
Conclusions:
- Ischemic stroke imposes a considerable economic burden, with the highest costs concentrated during initial hospitalization, especially for patients with disabilities or those who do not survive.
- Discharge status is a key determinant of both acute and long-term healthcare expenditures following ischemic stroke.
- These findings underscore the need for effective stroke prevention and management strategies to mitigate long-term economic consequences.
Objective:
The objective of this study was to estimate the acute healthcare costs of ischemic stroke during hospitalization and the quarterly all-cause healthcare costs for the first year after discharge by discharge status.
Methods:
Adult patients with a hospitalization with a diagnosis of ischemic stroke (ICD-9-CM: 434.xx or 436.xx) between 1 January 2006 and 31 March 2015 were identified from a large US commercial claims database. Patients were classified into three cohorts based on their discharge status from the first stroke hospitalization, i.e. dead at discharge, discharged with disability, or discharged without disability. Third-party (medical and pharmacy) and out-of-pocket costs were adjusted to 2015 USD.
Results:
A total of 7919 patients dead at discharge, 45,695 patients discharged with disability, and 153,778 patients discharged without disability were included in this analysis. The overall average age was 59.7 years and 52.3% were male. During hospitalization, mean total costs (third-party and out-of-pocket) were $68,370 for patients dead at discharge, $73,903 for patients discharged with disability, and $24,448 for patients discharged without disability (p < .001 for each pairwise comparison); mean third-party costs were $63,605 for patients dead at discharge, $67,861 for patients discharged with disability and $19,267 for patients discharged without disability (p < .001 for each pairwise comparison). During the first year after discharge, mean total costs for patients discharged with disability vs. without disability were $46,850 vs. $30,132 (p < .001). Mean third-party costs for patients discharged with disability vs. without disability were $19,116 vs. $10,976 during the first quarter after discharge, $10,236 vs. $6926 during the second quarter, $8241 vs. $5810 during the third quarter, and $6875 vs. $5292 during the fourth quarter (p < .001 for each quarter).
Conclusion:
The results demonstrated the high economic burden of ischemic stroke, especially among patients discharged with disability with the highest costs incurred during the inpatient stays.
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