This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roos, Y.B.W.E.M. Articles by Vermeulen, M. Search for Related Content PubMed PubMed Citation Articles by Roos, Y.B.W.E.M. Articles by Vermeulen, M. Related Collections Health policy and outcome research Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage Aneurysm, AVM, hematoma

(Stroke. 2002;33:1595.)
© 2002 American Heart Association, Inc.

Original Contributions

Direct Costs of Modern Treatment of Aneurysmal Subarachnoid Hemorrhage in the First Year After Diagnosis

Y.B.W.E.M. Roos, MD, PhD; M.G.W. Dijkgraaf, PhD; K.W. Albrecht, MD; L.F.M. Beenen, MD; R.J.M. Groen, MD, PhD; R.J. de Haan, PhD M. Vermeulen, MD, PhD

From the Departments of Neurology (Y.B.W.E.M.R., M.V.), Clinical Epidemiology and Biostatistics (M.G.W.D., R.J. d H.), and Neurosurgery (K.W.A.), Academic Medical Center, University of Amsterdam; Department of Neurosurgery (L.F.M.B.), Academic Hospital, Free University; and Department of Neurosurgery (R.J.M.G.), Slotervaart General Hospital, Amsterdam, the Netherlands.

Correspondence to Yvo Roos, MD, PhD, Department of Neurology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, Netherlands. E-mail Y.B.Roos{at}amc.uva.nl

Background and Purpose— The purpose of this study was to investigate the current direct costs of modern management of patients with aneurysmal subarachnoid hemorrhage in the first year after diagnosis.

Methods— During a 1-year period, we studied all admitted patients with subarachnoid hemorrhage from a population of 2 million people. We calculated the direct costs of treatment, which included the costs of medical and nursing care and the related travel expenses of patients. We calculated true costs for all major healthcare resources. National census data, if available, and standard charges were used to determine healthcare resource expenses.

Results— Hospital admissions and diagnostic and therapeutic interventions in 110 patients accounted for 85% of all costs; 64% of the total direct medical costs during admission were the medical, nursing, and overhead costs alone. Patients discharged directly to home generated 4% of the total budget, whereas admission to a nursing home accounted for the remaining 11% of the total costs. Of the diagnostic and therapeutic costs, 45% was caused by imaging and 42% by surgery or coiling. Angiography alone accounted for 52% of the total imaging costs and 24% of the total diagnostic and therapeutic costs. Prescribed medication accounted for only 3% of the total budget of diagnostic and therapeutic costs.

Conclusions— Most direct costs during the first year after aneurysmal subarachnoid hemorrhage are caused by the hospital inpatient days, accounting for two thirds of the total costs generated during the first year after the initial bleeding. If new costly treatments succeed in reducing the average length of inpatient hospital stays, then progress in therapy may prove cost effective and might even be cost saving.

Key Words: costs and cost analysis • subarachnoid hemorrhage • therapeutics

This article has been cited by other articles:

				J. P. Greving, G. J.E. Rinkel, E. Buskens, and A. Algra Cost-effectiveness of preventive treatment of intracranial aneurysms: New data and uncertainties Neurology, July 28, 2009; 73(4): 258 - 265. [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]

				M. J.H. Wermer, H. Koffijberg, I. C. van der Schaaf, and For the ASTRA Study Group Effectiveness and costs of screening for aneurysms every 5 years after subarachnoid hemorrhage Neurology, May 27, 2008; 70(22): 2053 - 2062. [Abstract] [Full Text] [PDF]

				J. I. Suarez, R. W. Tarr, and W. R. Selman Aneurysmal Subarachnoid Hemorrhage N. Engl. J. Med., January 26, 2006; 354(4): 387 - 396. [Full Text] [PDF]

				Y.B.W.E.M. Roos, G. Pals, P.M. Struycken, G.J.E. Rinkel, M. Limburg, J.C. Pronk, J.S.P. van den Berg, J.A.F.M. Luijten, P.L. Pearson, M. Vermeulen, et al. Genome-Wide Linkage in a Large Dutch Consanguineous Family Maps a Locus for Intracranial Aneurysms to Chromosome 2p13 Stroke, October 1, 2004; 35(10): 2276 - 2281. [Abstract] [Full Text] [PDF]

				M. J. Wilby, M. Sharp, P. C. Whitfield, P. J. Hutchinson, D. K. Menon, and P. J. Kirkpatrick Cost-Effective Outcome for Treating Poor-Grade Subarachnoid Hemorrhage Stroke, October 1, 2003; 34(10): 2508 - 2511. [Abstract] [Full Text] [PDF]