Lifetime cost of stroke in the United States
Lifetime cost of stroke in the United States
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DOI：
10.1161/01.str.27.9.1459
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发表时间：
1996-09-01
期刊：
影响因子：
8.3
通讯作者：
Jacobson, MF
中科院分区：
文献类型：
--
作者：
Taylor, TN;Davis, PH;Jacobson, MF
背景和目的脑卒中给个人和社会带来了巨大的经济负担。本研究估计与三种主要类型的中风：蛛网膜下腔出血（SAH），脑内出血（ICH），缺血性中风（ISC）相关的终生直接和间接成本。方法我们开发了一个模型，在1990年发生的中风事件的终生成本。基于文献综述，我们建立了卒中发病率、生存率和复发率的流行病学模型。治疗中风的直接费用数据来自医疗保险索赔数据、1987年国家医疗支出调查（NMES）和代表一组大型自保雇主的保险索赔数据。间接成本（放弃的市场和非市场生产的价值）与过早发病率和死亡率进行了估计的基础上，从美国经济分析局和1987年NMES.Results的数据发生在1990年的首次中风的人的终身成本估计为228 030美元SAH，123 565美元ICH，90 981美元ISC。所有中风亚型的平均值为103576美元。间接成本占寿命成本的58.0%。1990年与估计的392344例首次卒中相关的总终生成本为406亿美元：SAH为56亿美元，ICH为60亿美元，ISC为290亿美元。急性护理费用发生在2年后首次中风占45.0%，长期门诊卡尔占35.0%，和疗养院的成本占17.5%的总终身costsofstroke.Conclusions中风的终身成本有很大的不同类型的中风，并需要相当大的成本超过第2年中风后。
Background and Purpose Stroke imposes a substantial economic burden on individuals and society. This study estimates the Lifetime direct and indirect costs associated with the three major types of stroke: subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke (ISC).Methods We developed a model of the lifetime cost of incident strokes occurring in 1990. An epidemiological model of stroke incidence, survival, and recurrence was developed based on a review of the literature. Data on direct cost of treating stroke were obtained from Medicare claims data, the 1987 National Medical Expenditure Survey (NMES), and insurance claims data representing a group of large, self-insured employers. Indirect costs (the value of foregone market and nonmarket production) associated with premature morbidity and mortality were estimated based on data from the US Bureau of Economic Analysis and the 1987 NMES.Results The lifetime cost per person of first strokes occurring in 1990 is estimated to be $228 030 for SAH, $123 565 for ICH, $90 981 for ISC. and $103 576 averaged across all stroke subtypes. Indirect costs accounted for 58.0% of Lifetime costs. Aggregate lifetime cost associated with an estimated 392 344 first strokes in 1990 was $40.6 billion: $5.6 billion for SAH, $6.0 billion for ICH, and $29.0 billion for ISC. Acute-care costs incurred in the 2 years following a first stroke accounted for 45.0%, long-term ambulatory carl accounted for 35.0%, and nursing home costs accounted for 17.5% of aggregate lifetime costs of stroke.Conclusions The lifetime cost of stroke varies considerably by type of stroke and entails considerable costs beyond the first 2 years after a stroke.