Stefan Strilciuc1,2,3, Diana Alecsandra Grad2,3, Vlad Mixich3, Adina Stan1,2, Anca Dana Buzoianu4, Cristian Vladescu5,6, Mihaela Adela Vintan1,2. 1. Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, 4000012 Cluj-Napoca, Cluj, Romania. 2. RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400354 Cluj-Napoca, Cluj, Romania. 3. Department of Public Health, Babes-Bolyai University, No. 7 Pandurilor Street, 400376 Cluj-Napoca, Cluj, Romania. 4. Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Cluj, Romania. 5. National School of Public Health Management and Professional Development, No 31 Vaselor, Street, 030167 Bucharest, Romania. 6. Department of Public Health, University of Medicine and Pharmacy Victor Babes, No.2 Eftimie Murgu Square, 300041 Timisoara, Timis, Romania.
Abstract
BACKGROUND: Health policies in transitioning health systems are rarely informed by the economic burden of disease due to scanty access to data. This study aimed to estimate direct and indirect costs for first-ever acute ischemic stroke (AIS) during the first year for patients residing in Cluj, Romania, and hospitalized in 2019 at the County Emergency Hospital (CEH). METHODS: The study was conducted using a mixed, retrospective costing methodology from a societal perspective to measure the cost of first-ever AIS in the first year after onset. Patient pathways for AIS were reconstructed to aid in mapping inpatient and outpatient cost items. We used anonymized administrative and clinical data at the hospital level and publicly available databases. RESULTS: The average cost per patient in the first year after stroke onset was RON 25,297.83 (EUR 5226.82), out of which 80.87% were direct costs. The total cost in Cluj, Romania in 2019 was RON 17,455,502.7 (EUR 3,606,505.8). CONCLUSIONS: Our costing exercise uncovered shortcomings of stroke management in Romania, particularly related to acute care and neurorehabilitation service provision. Romania spends significantly less on healthcare than other countries (5.5% of GDP vs. 9.8% European Union average), exposing stroke survivors to a disproportionately high risk for preventable and treatable post-stroke disability.
BACKGROUND: Health policies in transitioning health systems are rarely informed by the economic burden of disease due to scanty access to data. This study aimed to estimate direct and indirect costs for first-ever acute ischemic stroke (AIS) during the first year for patients residing in Cluj, Romania, and hospitalized in 2019 at the County Emergency Hospital (CEH). METHODS: The study was conducted using a mixed, retrospective costing methodology from a societal perspective to measure the cost of first-ever AIS in the first year after onset. Patient pathways for AIS were reconstructed to aid in mapping inpatient and outpatient cost items. We used anonymized administrative and clinical data at the hospital level and publicly available databases. RESULTS: The average cost per patient in the first year after stroke onset was RON 25,297.83 (EUR 5226.82), out of which 80.87% were direct costs. The total cost in Cluj, Romania in 2019 was RON 17,455,502.7 (EUR 3,606,505.8). CONCLUSIONS: Our costing exercise uncovered shortcomings of stroke management in Romania, particularly related to acute care and neurorehabilitation service provision. Romania spends significantly less on healthcare than other countries (5.5% of GDP vs. 9.8% European Union average), exposing stroke survivors to a disproportionately high risk for preventable and treatable post-stroke disability.
Entities:
Keywords:
cost of stroke; first-ever stroke; societal perspective
Authors: M Chiumente; M M Gianino; D Minniti; T J Mattei; B Spass; K M Kamal; D E Zimmerman; A Muca; E Luda Journal: Int J Stroke Date: 2015-04-08 Impact factor: 5.266
Authors: K Rossnagel; C H Nolte; J Muller-Nordhorn; G J Jungehulsing; D Selim; B Bruggenjurgen; A Villringer; S N Willich Journal: Eur J Neurol Date: 2005-11 Impact factor: 6.089
Authors: Robert Heggie; Olivia Wu; Phil White; Gary A Ford; Joanna Wardlaw; Martin M Brown; Andrew Clifton; Keith W Muir Journal: Int J Stroke Date: 2019-09-30 Impact factor: 5.266
Authors: Adrian Gheorghe; Ulla Griffiths; Adrianna Murphy; Helena Legido-Quigley; Peter Lamptey; Pablo Perel Journal: BMC Public Health Date: 2018-08-06 Impact factor: 3.295
Authors: Vidya Ramkumar; Roopa Nagarajan; Vanaja C Shankarnarayan; Selvakumar Kumaravelu; James W Hall Journal: BMC Health Serv Res Date: 2019-01-03 Impact factor: 2.655