(Stroke. 1995;26:1830-1836.)
© 1995 American Heart Association, Inc.
Articles |
Costs of Medical Care After First-Ever Stroke in the Netherlands
From the Center for Clinical Decision Sciences, Department of Public Health (L.B., J.D.F.H.), Erasmus University, Rotterdam; and the Departments of Epidemiology and Biostatistics (J.H.P. van der M.) and Neurology (M.L.), Academic Medical Center, Amsterdam, Netherlands.
Correspondence to L. Bergman, MD, PhD, Center for Clinical Decision Sciences, Department of Public Health, Erasmus University, PO Box 1738, 3000 DR Rotterdam, Netherlands.
Background and Purpose Stroke causes high morbidity and mortality. The aging of the population further increases the demands on healthcare costs.
Methods We estimated the lifetime direct costs of care of first-ever stroke patients in the Netherlands in 1991 using epidemiological data from national and international studies. In addition, we examined the effect of an aging population on future healthcare costs.
Results The lifetime costs for 24 007 first-ever stroke patients are estimated to be 1870 million Dutch guilders (Dfl) (1 Dfl=0.53 US dollar, 1991). Per-person costs are higher for women (83 000 Dfl) than for men (71 000 Dfl). The major cost component of first-year costs is hospital costs (45%), while nursing home costs dominate lifetime costs (50%). An increase of the elderly population older than 65 years of 27% between 1991 and 2010 might lead to a parallel increase of total costs of 30%, or 1.5% per year.
Conclusions Long-term care rather than acute care dominates the lifetime costs for stroke patients now and in the future.
Key Words: costs and cost analysis • Netherlands • stroke
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|
|
|
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|
|
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