Published online before print September 11, 2003, doi: 10.1161/01.STR.0000091395.85357.09
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2003;34:2502.)
© 2003 American Heart Association, Inc.
Original Contributions |
Lifetime Cost of Stroke Subtypes in Australia
Findings From the North East Melbourne Stroke Incidence Study (NEMESIS)
From the National Stroke Research Institute (H.M.D., A.G.T., G.A.D.) and Neurology Department (H.M.D., R.A.L.M., G.A.D.), Austin & Repatriation Medical Centre, Heidelberg; Department of Medicine, University of Melbourne, Melbourne (H.M.D., R.A.L.M., G.A.D.); Department of Epidemiology and Preventive Medicine, Monash Medical School, Alfred Hospital, Prahran (A.G.T., J.J.M.); and Centre for Health Program Evaluation, Department of Public Health, University of Melbourne, Heidelberg Heights (C.M., R.C.), Australia.
Correspondence to Dr Helen Dewey, National Stroke Research Institute, Level 1, Neurosciences Bldg, Repatriation Campus, Austin & Repatriation Medical Centre, 300 Waterdale Rd, Heidelberg Heights, Victoria 3081, Australia. E-mail helend{at}austin.unimelb.edu au
Background and Purpose— Little is known about any variations in resource use and costs of care between stroke subtypes, especially nonhospital costs. The purpose of this study was to describe the patterns of resource use and to estimate the first-year and lifetime costs for stroke subtypes.
Methods— A cost-of-illness model was used to estimate the total first-year costs and lifetime costs of stroke subtypes for all strokes (subarachnoid hemorrhages excluded) that occurred in Australia during 1997. For each subtype, average cost per case during the first year and the present value of average cost per case over a lifetime were calculated. Resource use data obtained in the North East Melbourne Stroke Incidence Study (NEMESIS) were used.
Results— The present value of total lifetime costs for all strokes was Aus $1.3 billion (US $985 million). Total lifetime costs were greatest for ischemic stroke (72%; Aus $936.8 million; US $709.7 million), followed by intracerebral hemorrhage (26%; Aus $334.5 million; US $253.4 million) and unclassified stroke (2%; Aus $30 million; US $22.7 million). The average cost per case during the first year was greatest for total anterior circulation infarction (Aus $28 266). Over a lifetime, the present value of average costs was greatest for intracerebral hemorrhage (Aus $73 542), followed by total anterior circulation infarction (Aus $53 020), partial anterior circulation infarction (Aus $50 692), posterior circulation infarction (Aus $37 270), lacunar infarction (Aus $34 470), and unclassified stroke (Aus $12 031).
Conclusions— First-year and lifetime costs vary considerably between stroke subtypes. Variation in average length of total hospital stay is the main explanation for differences in first-year costs.
Key Words: Australia • costs and cost analysis • incidence • stroke • stroke classification
This article has been cited by other articles:
 |
|
 |
|
  E. Perkins, J. Stephens, H. Xiang, and W. Lo The Cost of Pediatric Stroke Acute Care in the United States Stroke, August 1, 2009; 40(8): 2820 - 2827. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Miller, Z. Quayyum, P. McNamee, R. Al-Shahi Salman, and on behalf of the SIVMS Steering Committee Economic Burden of Intracranial Vascular Malformations in Adults: Prospective Population-Based Study Stroke, June 1, 2009; 40(6): 1973 - 1979. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Cadilhac, R. Carter, A. G. Thrift, and H. M. Dewey Estimating the Long-Term Costs Of Ischemic and Hemorrhagic Stroke for Australia: New Evidence Derived From the North East Melbourne Stroke Incidence Study (NEMESIS) Stroke, March 1, 2009; 40(3): 915 - 921. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Luengo-Fernandez, A. M. Gray, and P. M. Rothwell Costs of Stroke Using Patient-Level Data: A Critical Review of the Literature Stroke, February 1, 2009; 40(2): e18 - e23. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S F Hurley and J P Matthews Cost-effectiveness of the Australian National Tobacco Campaign Tob. Control, December 1, 2008; 17(6): 379 - 384. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Glozier, M. L. Hackett, V. Parag, C. S. Anderson, and for the Auckland Regional Community Stroke (ARCOS) The Influence of Psychiatric Morbidity on Return to Paid Work After Stroke in Younger Adults: The Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003 Stroke, May 1, 2008; 39(5): 1526 - 1532. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Lo, K. Zamel, K. Ponnappa, A. Allen, D. Chisolm, M. Tang, B. Kerlin, and K. O. Yeates The Cost of Pediatric Stroke Care and Rehabilitation Stroke, January 1, 2008; 39(1): 161 - 165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. S. Ng, J. Stein, M. Ning, and R. M. Black-Schaffer Comparison of Clinical Characteristics and Functional Outcomes of Ischemic Stroke in Different Vascular Territories Stroke, August 1, 2007; 38(8): 2309 - 2314. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Luengo-Fernandez, A. M. Gray, and P. M. Rothwell Population-Based Study of Determinants of Initial Secondary Care Costs of Acute Stroke in the United Kingdom Stroke, October 1, 2006; 37(10): 2579 - 2587. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Dalziel, L. Segal, and M. de Lorgeril A Mediterranean Diet Is Cost-Effective in Patients with Previous Myocardial Infarction J. Nutr., July 1, 2006; 136(7): 1879 - 1885. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. L. Kolominsky-Rabas, P. U. Heuschmann, D. Marschall, M. Emmert, N. Baltzer, B. Neundorfer, O. Schoffski, K. J. Krobot, and for the CompetenceNet Stroke Lifetime Cost of Ischemic Stroke in Germany: Results and National Projections From a Population-Based Stroke Registry: The Erlangen Stroke Project Stroke, May 1, 2006; 37(5): 1179 - 1183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. S.J. Miller, M. F. Drummond, L. K. Langkilde, J. J.V. McMurray, and M. Ogren Economic factors associated with antithrombotic treatments for stroke prevention in patients with atrial fibrillation Eur. Heart J. Suppl., May 1, 2005; 7(suppl_C): C41 - C54. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Matchar and A. G. Rudd Health Policy and Outcomes Research 2004 Stroke, February 1, 2005; 36(2): 225 - 227. [Full Text] [PDF]
|
|
|
|
|
|
P. S.J. Miller, F. L. Andersson, and L. Kalra Are Cost Benefits of Anticoagulation for Stroke Prevention in Atrial Fibrillation Underestimated? Stroke, February 1, 2005; 36(2): 360 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L Jackson, G. M Peterson, and J. H Vial A Community-Based Educational Intervention to Improve Antithrombotic Drug Use in Atrial Fibrillation Ann. Pharmacother., November 1, 2004; 38(11): 1794 - 1799. [Abstract] [Full Text] [PDF]
|
|