The economic burden of intracerebral hemorrhage: evidence from managed care.

Data from the Integrated Healthcare Information Services managed care database were used to estimate per-patient costs of intracerebral hemorrhage (ICH) for up to one year after an initial ICH event. Plan enrollees (age > or = 18 yr) hospitalized with a primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis of ICH (431.xx) during July 1999 to June 2002 were selected. Resource utilization/costs associated with the initial hospitalization were calculated for all patients. Postdischarge use/cost of health care services (repeat hospitalization, skilled nursing/rehabilitation services, outpatient use, pharmacy) were estimated for up to 365 days after hospital discharge for patients surviving the initial stay. Forty-six percent of the 493 patients selected were at least 65 years of age and 60% had private health insurance. Patients who died during their initial ICH hospitalization (N = 189 [38.4%]) incurred average treatment costs of $16,466. Survivors incurred initial hospitalization costs of $28,360 and first-year postdischarge costs of $16,035. Among survivors, 8% had repeat hospitalizations and 41% required inpatient skilled nursing/rehabilitation. Treatment costs for ICH to private payers appear to be considerable and may reflect a sizable long-term financial burden to U.S. health plans.