Lifetime cost of stroke subtypes in Australia findings from the North East Melbourne Stroke Incidence Study (NEMESIS)
Lifetime cost of stroke subtypes in Australia findings from the North East Melbourne Stroke Incidence Study (NEMESIS)
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DOI：
10.1161/01.str.0000091395.85357.09
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发表时间：
2003-10-01
期刊：
影响因子：
8.3
通讯作者：
Donnan, GA
中科院分区：
文献类型：
--
作者：
Dewey, HM;Thrift, AG;Donnan, GA
背景和目的：对于不同脑卒中亚型之间的资源使用和护理费用，特别是非医院费用的差异知之甚少。本研究的目的是描述资源使用的模式，并估计卒中亚型的第一年和终生成本。方法：采用疾病成本模型估计1997年澳大利亚发生的所有中风亚型（蛛网膜下腔出血除外）的第一年总成本和终生成本。对于每个亚型，计算第一年每个病例的平均成本和整个生命周期中每个病例的平均成本的现值。资源使用数据来自东北墨尔本卒中发生率研究（NEMESIS）。结果：所有中风患者一生总成本的现值为13亿澳元（9.85亿美元）。缺血性卒中的总终生成本最高（72%；9.368亿澳元；7.097亿美元），其次是脑出血（26%；3.345亿澳元；2.534亿美元）和未分类卒中（2%；3000万澳元；2270万美元）。第一年每个病例的平均费用最高的是全前循环梗死（28266澳元）。在一生中，平均成本现值最高的是脑出血（73 542澳元），其次是完全前循环梗死（53 020澳元）、部分前循环梗死（50 692澳元）、后循环梗死（37 270澳元）、腔隙性梗死（34 470澳元）和未分类中风（12 031澳元）。结论：不同脑卒中亚型的第一年和终生成本差异很大。平均总住院时间的差异是第一年费用差异的主要解释。
Background and Purpose-Little is known about any variations in resource use and costs of care between stroke subtypes, especially nonhospital costs. The purpose of this study was to describe the patterns of resource use and to estimate the first-year and lifetime costs for stroke subtypes.Methods-A cost-of-illness model was used to estimate the total first-year costs and lifetime costs of stroke subtypes for all strokes (subarachnoid hemorrhages excluded) that occurred in Australia during 1997. For each subtype, average cost per case during the first year and the present value of average cost per case over a lifetime were calculated. Resource use data obtained in the North East Melbourne Stroke Incidence Study (NEMESIS) were used.Results-The present value of total lifetime costs for all strokes was Aus $1.3 billion (US $985 million). Total lifetime costs were greatest for ischemic stroke (72%; Aus $936.8 million; US $709.7 million), followed by intracerebral hemorrhage (26%; Aus $334.5 million; US $253.4 million) and unclassified stroke (2%; Aus $30 million; US $22.7 million). The average cost per case during the first year was greatest for total anterior circulation infarction (Aus $28 266). Over a lifetime, the present value of average costs was greatest for intracerebral hemorrhage (Aus $73 542), followed by total anterior circulation infarction (Aus $53 020), partial anterior circulation infarction (Aus $50 692), posterior circulation infarction (Aus $37 270), lacunar infarction (Aus $34 470), and unclassified stroke (Aus $12 031).Conclusions-First-year and lifetime costs vary considerably between stroke subtypes. Variation in average length of total hospital stay is the main explanation for differences in first-year costs.