Seong-Eun Kim1, Heeyoung Lee1, Jun Yup Kim1, Keon-Joo Lee1, Jihoon Kang1, Beom Joon Kim1, Moon-Ku Han1, Kang-Ho Choi1, Joon-Tae Kim1, Dong-Ick Shin1, Min-Ju Yeo1, Jae-Kwan Cha1, Dae-Hyun Kim1, Hyun-Wook Nah1, Dong-Eog Kim1, Wi-Sun Ryu1, Jong-Moo Park1, Kyusik Kang1, Jae Guk Kim1, Soo Joo Lee1, Mi-Sun Oh1, Kyung-Ho Yu1, Byung-Chul Lee1, Hong-Kyun Park1, Keun-Sik Hong1, Yong-Jin Cho1, Jay Chol Choi1, Sung Il Sohn1, Jeong-Ho Hong1, Moo-Seok Park1, Tai Hwan Park1, Sang-Soon Park1, Kyung Bok Lee1, Jee-Hyun Kwon1, Wook-Joo Kim1, Jun Lee1, Ji Sung Lee1, Juneyoung Lee1, Atte Meretoja1, Philip B Gorelick1, Hee-Joon Bae2. 1. Department of Neurology and Cerebrovascular Center (S.-E.K., J.Y.K., K.-J.L, J.K., B.J.K, M.-K.H., H.-J.B) and Department of Clinical Preventive Medicine (H.L.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Department of Neurology (K.-H.C, J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (J.-K.C., D.-H.K., H.-W.N.), Dong-A University Hospital, Dong-A University College of Medicine, Busan; Department of Neurology (D.-E.K., W.-S.R.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Seoul; Department of Neurology (J.-G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (M.-S.O., K.-H.Y., B.-C.L.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (H.-K.P., K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Department of Neurology (M.-S.P., T.H.P., S.-S.P.), Seoul Medical Center; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, College of Medicine, Seoul; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University Hospital, Ulsan University College of Medicine; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul, Republic of Korea; Department of Neurology (A.M.), Helsinki University Central Hospital, Finland; and Davee Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Chicago, IL. 2. Department of Neurology and Cerebrovascular Center (S.-E.K., J.Y.K., K.-J.L, J.K., B.J.K, M.-K.H., H.-J.B) and Department of Clinical Preventive Medicine (H.L.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Department of Neurology (K.-H.C, J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (J.-K.C., D.-H.K., H.-W.N.), Dong-A University Hospital, Dong-A University College of Medicine, Busan; Department of Neurology (D.-E.K., W.-S.R.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Seoul; Department of Neurology (J.-G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (M.-S.O., K.-H.Y., B.-C.L.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (H.-K.P., K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Department of Neurology (M.-S.P., T.H.P., S.-S.P.), Seoul Medical Center; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, College of Medicine, Seoul; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University Hospital, Ulsan University College of Medicine; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul, Republic of Korea; Department of Neurology (A.M.), Helsinki University Central Hospital, Finland; and Davee Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Chicago, IL. braindoc@snu.ac.kr.
Abstract
OBJECTIVE: Stroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials. METHODS: We analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score. RESULTS: Between January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0-5 years). Mean cumulative cost over 5 years was $117,576 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score (p < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke. CONCLUSIONS: We show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.
OBJECTIVE:Stroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials. METHODS: We analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score. RESULTS: Between January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0-5 years). Mean cumulative cost over 5 years was $117,576 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score (p < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke. CONCLUSIONS: We show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.
Authors: Ashlee Wheaton; Patrick T Fok; Jessalyn K Holodinsky; Peter Vanberkel; David Volders; Noreen Kamal Journal: Front Neurol Date: 2021-12-17 Impact factor: 4.003
Authors: Robert W Regenhardt; Michael J Young; Mark R Etherton; Alvin S Das; Christopher J Stapleton; Aman B Patel; Michael H Lev; Joshua A Hirsch; Natalia S Rost; Thabele M Leslie-Mazwi Journal: J Neurointerv Surg Date: 2020-10-30 Impact factor: 8.572