The medical economics of stroke.

The economic consequences of the approximately 500,000 strokes that occur each year in the US are staggering. The direct cost of providing care for stroke victims in 1993 has been estimated to be $US17 billion, with an additional $US13 billion in indirect costs attributable to lost earnings due to stroke-related mortality and morbidity. Estimates of the cost of stroke over a patient's lifetime vary according to age at first stroke and type of stroke. In 1990, these estimates ranged from $US91,000 for ischaemic stroke, $US124,000 for intracerebral haemorrhage, and $US228,000 for subarachnoid haemorrhage. Factors driving the economics of stroke include the epidemiology of stroke, treatment patterns and settings, and social and behavioural factors. Evaluating the economic consequences of alternative interventions designed to prevent strokes or improve stroke outcomes involves a weighing of incremental costs and effectiveness. Previous efforts have focused primarily on measuring costs, with a recent shift to trying to measure patient preferences for stroke outcomes.