Related Experiment Video
Updated: Oct 19, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Trends in healthcare resource use and expenditure before and after ischaemic stroke. A population-based study
A Ribera1, E Vela2, A García-Altés3
1Unidad de Epidemiología Cardiovascular, Hospital Universitario Vall d'Hebron, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Pla Director de la Malaltia Vascular Cerebral, Departament de Salut, Generalitat de Catalunya, Spain.
Insights
Ischaemic stroke significantly increases healthcare costs, mainly due to initial hospitalisation and rehabilitation in the first year. Costs remain elevated post-stroke, highlighting the need for better stroke service planning.
Area of Science:
- Public Health
- Health Economics
- Stroke Medicine
Background:
- Stroke poses a growing healthcare and socioeconomic challenge despite improved survival rates.
- Understanding post-stroke resource utilization and expenditure is crucial for healthcare planning.
Purpose of the Study:
- To analyze patient characteristics, resource use, and healthcare expenditure one year before and three years after ischaemic stroke.
- To identify key cost drivers in the post-stroke period.
Main Methods:
- Utilized a population-based dataset from the Catalan Health Service (2012-2016).
- Linked patient data from one year pre-stroke to three years post-stroke.
- Described annual and monthly resource use and healthcare expenditure per patient.
Main Results:
- Identified 36,044 ischaemic stroke patients (mean age 74.7 years); 3-year survival rate was 63%.
- Average expenditure increased from €3230 pre-stroke to €11,060 in year 1 post-stroke, then decreased but remained elevated (€4104 year 2, €3878 year 3).
- First-year costs driven by hospitalisation (45%) and rehabilitation (33%); subsequent costs by admissions and medications.
Conclusions:
- Initial hospitalisation is the primary driver of increased healthcare expenditure post-ischaemic stroke.
- Expenditure remains above baseline levels even after the first year.
- Population-based data is valuable for optimizing stroke service planning.
Introduction:
Despite improved survival rates, stroke represents an increasing healthcare and socioeconomic burden. We describe the main characteristics of patients with ischaemic stroke and resource use and associated expenditure one year before and 3 years after stroke, using a population-based dataset.
Methods:
The information technology systems of the Catalan Health Service were used to identify patients with ischaemic strokes occurring between January 2012 and December 2016. For each patient, information from one year before the stroke and up to 3 years thereafter was linked across databases. We describe annual and monthly resource use and healthcare expenditure per patient.
Results:
We identified 36 044 patients with ischaemic stroke (mean age, 74.7 ± 13.3 years). The survival rate at 3 years was 63%. Average expenditure per patient was €3230 the year before stroke, €11 060 for year 1 after stroke, €4104 for year 2, and €3878 for year 3. The greatest determinants of cost in year 1 were hospitalisation (including initial hospitalisation), representing 45% of the difference in expenditure compared to the previous year, and convalescence and rehabilitation services, representing 33% of this difference. After year one, the increase in expenditure was mainly determined by additional hospital admissions and drug treatment.
Conclusion:
After ischaemic stroke, healthcare expenditure increases primarily because of initial hospitalisation. After year one, the expenditure decreases but remains above baseline values. Information from population-based datasets is useful for improving the planning of stroke services.
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...