on April 8, 2004
Published online before print April 8, 2004, doi: 10.1161/01.STR.0000125860.48180.48
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Submitted on October 24, 2003
From Care and Public Health Research Institute (CAPHRI) of Maastricht University (S.M.A.A.E., A.J.H.A.A.), Department of Health Organization, Policy and Economics, Maastricht University, Faculty of Health Sciences, Maastricht, the Netherlands; Department of Prevention and Health Services Research (S.M.A.A.E., J.N.S., M.L.L.v.G., J.H.C.J., G.A.M.v.d.B.), National Institute of Public Health and the Environment, Bilthoven, the Netherlands; Mapi Values the Netherlands (M.L.L.v.G.), the Netherlands; and Department of Social Medicine (G.A.M.v.d.B.), Academic Medical Centre, University of Amsterdam, Amsterdam. * To whom correspondence should be addressed. E-mail: S.Evers{at}BEOZ.unimaas.nl.
Purpose--With the rapid international spread of interventions, there is a need to understand the economic implications of these changes and to interpret these economic implications on the international level. The purpose of this study is to systematically compare total health care expenditures on stroke, the costs of stroke per capita, and the distribution of stroke costs within different countries, with special attention to the allocation of resources among different health care facilities. Methods--Studies for this literature review were selected by conducting a literature search from January 1966 to July 2003. Key methodological, country-related, and monetary issues of the selected stroke cost studies were evaluated using a checklist. Results--After selection, 25 stroke cost studies were reviewed. Although the selected cost of illness studies used different methodologies, the estimated expenditures for stroke are approximately similar. The proportion of national health care in the 8 countries studied is unequivocal for the more recent studies, ie, Conclusions--This study highlights the importance of studying the economic consequences of stroke and of interpreting the results on the international level. The results of stroke cost studies provide insight into the distribution of the costs of stroke and the impact of stroke on the national expenditure on health care.
Revised on January 14, 2004
Accepted on January 20, 2004
International Comparison of Stroke Cost Studies
Silvia M.A.A. Evers PhD*;
3% of total health care expenditures. A shift is observed from the inpatient treatment costs (in the first year) toward outpatient treatment and long-term care costs (in the latter years). Furthermore, it is remarkable that in the studies, little attention is paid to costs borne by the patient and family or to the costs of comorbidity.
Key words: cost and cost analysis • internationality • health resources
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