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Economic burden of stroke: a systematic review on post-stroke care

Author

Listed:
  • S. Rajsic

    (UMIT-University for Health Sciences, Medical Informatics and Technology)

  • H. Gothe

    (UMIT-University for Health Sciences, Medical Informatics and Technology
    Technical University Dresden)

  • H. H. Borba

    (UMIT-University for Health Sciences, Medical Informatics and Technology
    Federal University of Paraná)

  • G. Sroczynski

    (UMIT-University for Health Sciences, Medical Informatics and Technology)

  • J. Vujicic

    (University of Belgrade)

  • T. Toell

    (Medical University of Innsbruck)

  • Uwe Siebert

    (UMIT-University for Health Sciences, Medical Informatics and Technology
    Harvard Chan School of Public Health
    Massachusetts General Hospital, Harvard Medical School)

Abstract

Objectives Stroke is a leading cause for disability and morbidity associated with increased economic burden due to treatment and post-stroke care (PSC). The aim of our study is to provide information on resource consumption for PSC, to identify relevant cost drivers, and to discuss potential information gaps. Methods A systematic literature review on economic studies reporting PSC-associated data was performed in PubMed/MEDLINE, Scopus/Elsevier and Cochrane databases, Google Scholar and gray literature ranging from January 2000 to August 2016. Results for post-stroke interventions (treatment and care) were systematically extracted and summarized in evidence tables reporting study characteristics and economic outcomes. Economic results were converted to 2015 US Dollars, and the total cost of PSC per patient month (PM) was calculated. Results We included 42 studies. Overall PSC costs (inpatient/outpatient) were highest in the USA ($4850/PM) and lowest in Australia ($752/PM). Studies assessing only outpatient care reported the highest cost in the United Kingdom ($883/PM), and the lowest in Malaysia ($192/PM). Fifteen different segments of specific services utilization were described, in which rehabilitation and nursing care were identified as the major contributors. Conclusion The highest PSC costs were observed in the USA, with rehabilitation services being the main cost driver. Due to diversity in reporting, it was not possible to conduct a detailed cost analysis addressing different segments of services. Further approaches should benefit from the advantages of administrative and claims data, focusing on inpatient/outpatient PSC cost and its predictors, assuring appropriate resource allocation.

Suggested Citation

  • S. Rajsic & H. Gothe & H. H. Borba & G. Sroczynski & J. Vujicic & T. Toell & Uwe Siebert, 2019. "Economic burden of stroke: a systematic review on post-stroke care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 107-134, February.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:1:d:10.1007_s10198-018-0984-0
    DOI: 10.1007/s10198-018-0984-0
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    References listed on IDEAS

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    1. Mattias Ekman, 2004. "Economic evidence in stroke: a review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(1), pages 74-83, October.
    2. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
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    7. Uwe Siebert, 2003. "When should decision-analytic modeling be used in the economic evaluation of health care?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 143-150, September.
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    2. Ghislaine van Mastrigt & Caroline van Heugten & Anne Visser-Meily & Leonarda Bremmers & Silvia Evers, 2022. "Estimating the Burden of Stroke: Two-Year Societal Costs and Generic Health-Related Quality of Life of the Restore4Stroke Cohort," IJERPH, MDPI, vol. 19(17), pages 1-15, September.
    3. Srujitha Marupuru & Melanie L. Bell & Michael A. Grandner & Ruth E. Taylor-Piliae, 2022. "The Effect of Physical Activity on Sleep Quality among Older Stroke Survivors: Secondary Analysis from a Randomized Controlled Trial," IJERPH, MDPI, vol. 19(20), pages 1-10, October.
    4. Benjamin Kass & Christina Dornquast & Andreas Meisel & Christine Holmberg & Nina Rieckmann & Thomas Reinhold, 2021. "Cost-effectiveness of patient navigation programs for stroke patients–A systematic review," PLOS ONE, Public Library of Science, vol. 16(10), pages 1-12, October.
    5. Xuan Qiu & Yicheng Gao & Zhaoxu Zhang & Sijia Cheng & Shuangmei Zhang, 2021. "Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-23, April.

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    More about this item

    Keywords

    Stroke; Cerebrovascular accident; Post-stroke care; Rehabilitation; Economic evaluation; Cost;
    All these keywords.

    JEL classification:

    • I19 - Health, Education, and Welfare - - Health - - - Other

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