Leander R Buisman1, Siok Swan Tan2, Paul J Nederkoorn2, Peter J Koudstaal2, William K Redekop2. 1. From the Institute of Health Policy and Management (L.R.B., S.S.T., W.K.R.) and the Institute for Medical Technology Assessment (L.R.B., S.S.T., W.K.R.), Erasmus University Rotterdam; the Department of Neurology (P.J.N.), Academic Medical Center, University of Amsterdam; and the Department of Neurology (P.J.K.), Erasmus MC, University Medical Center Rotterdam, the Netherlands. buisman@bmg.eur.nl. 2. From the Institute of Health Policy and Management (L.R.B., S.S.T., W.K.R.) and the Institute for Medical Technology Assessment (L.R.B., S.S.T., W.K.R.), Erasmus University Rotterdam; the Department of Neurology (P.J.N.), Academic Medical Center, University of Amsterdam; and the Department of Neurology (P.J.K.), Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Abstract
OBJECTIVES: There have been no ischemic stroke costing studies since major improvements were implemented in stroke care. We therefore determined hospital resource use and costs of ischemic stroke and TIA in the Netherlands for 2012. METHODS: We conducted a retrospective cost analysis using individual patient data from a national diagnosis-related group registry. We analyzed 4 subgroups: inpatient ischemic stroke, inpatient TIA, outpatient ischemic stroke, and outpatient TIA. Costs of carotid endarterectomy and costs of an extra follow-up visit were also estimated. Unit costs were based on reference prices from the Dutch Healthcare Insurance Board and tariffs provided by the Dutch Healthcare Authority. Linear regression analysis was used to examine the association between hospital costs and various patient and hospital characteristics. RESULTS: A total of 35,903 ischemic stroke and 21,653 TIA patients were included. Inpatient costs were €5,328 ($6,845) for ischemic stroke and €2,470 ($3,173) for TIA. Outpatient costs were €495 ($636) for ischemic stroke and €587 ($754) for TIA. Costs of carotid endarterectomy were €6,836 ($8,783). Costs of inpatient days were the largest contributor to hospital costs. Age, hospital type, and region were strongly associated with hospital costs. CONCLUSIONS: Hospital costs are higher for inpatients and ischemic strokes compared with outpatients and TIAs, with length of stay (LOS) the most important contributor. LOS and hospital costs have substantially declined over the last 10 years, possibly due to improved hospital stroke care and efficient integrated stroke services.
OBJECTIVES: There have been no ischemic stroke costing studies since major improvements were implemented in stroke care. We therefore determined hospital resource use and costs of ischemic stroke and TIA in the Netherlands for 2012. METHODS: We conducted a retrospective cost analysis using individual patient data from a national diagnosis-related group registry. We analyzed 4 subgroups: inpatient ischemic stroke, inpatient TIA, outpatientischemic stroke, and outpatient TIA. Costs of carotid endarterectomy and costs of an extra follow-up visit were also estimated. Unit costs were based on reference prices from the Dutch Healthcare Insurance Board and tariffs provided by the Dutch Healthcare Authority. Linear regression analysis was used to examine the association between hospital costs and various patient and hospital characteristics. RESULTS: A total of 35,903 ischemic stroke and 21,653 TIA patients were included. Inpatient costs were €5,328 ($6,845) for ischemic stroke and €2,470 ($3,173) for TIA. Outpatient costs were €495 ($636) for ischemic stroke and €587 ($754) for TIA. Costs of carotid endarterectomy were €6,836 ($8,783). Costs of inpatient days were the largest contributor to hospital costs. Age, hospital type, and region were strongly associated with hospital costs. CONCLUSIONS: Hospital costs are higher for inpatients and ischemic strokes compared with outpatients and TIAs, with length of stay (LOS) the most important contributor. LOS and hospital costs have substantially declined over the last 10 years, possibly due to improved hospital stroke care and efficient integrated stroke services.
Authors: Pierre Amarenco; Julien Bogousslavsky; Alfred Callahan; Larry B Goldstein; Michael Hennerici; Amy E Rudolph; Henrik Sillesen; Lisa Simunovic; Michael Szarek; K M A Welch; Justin A Zivin Journal: N Engl J Med Date: 2006-08-10 Impact factor: 91.245
Authors: Peter L Kolominsky-Rabas; Peter U Heuschmann; Daniela Marschall; Martin Emmert; Nikoline Baltzer; Bernhard Neundörfer; Oliver Schöffski; Karl J Krobot Journal: Stroke Date: 2006-03-30 Impact factor: 7.914
Authors: Pelham Barton; James P Sheppard; Cristina M Penaloza-Ramos; Sue Jowett; Gary A Ford; Daniel Lasserson; Jonathan Mant; Ruth M Mellor; Tom Quinn; Peter M Rothwell; David Sandler; Don Sims; Richard J McManus Journal: BMJ Open Date: 2017-11-25 Impact factor: 2.692
Authors: Joe L P Kolkert; Rolf H H Groenwold; Vanessa J Leijdekkers; Joep Ter Haar; Clark J Zeebregts; Anco Vahl Journal: World J Surg Date: 2017-11 Impact factor: 3.352
Authors: Elles Douven; Sebastian Köhler; Maria M F Rodriguez; Julie Staals; Frans R J Verhey; Pauline Aalten Journal: Neuropsychol Rev Date: 2017-08-22 Impact factor: 7.444
Authors: Alexander V van Schoonhoven; Judith J Gout-Zwart; Marijke J S de Vries; Antoinette D I van Asselt; Evgeni Dvortsin; Pepijn Vemer; Job F M van Boven; Maarten J Postma Journal: PLoS One Date: 2019-09-06 Impact factor: 3.240
Authors: Leander R Buisman; Adriana J Rijnsburger; Heleen M den Hertog; Aad van der Lugt; William K Redekop Journal: Appl Health Econ Health Policy Date: 2016-02 Impact factor: 2.561
Authors: Jeroen T J M van Dijck; Cassidy Q B Mostert; Alexander P A Greeven; Erwin J O Kompanje; Wilco C Peul; Godard C W de Ruiter; Suzanne Polinder Journal: Acta Neurochir (Wien) Date: 2020-05-14 Impact factor: 2.216