Direct Medical Cost of Hospitalization for Acute Stroke in Lebanon: A Prospective Incidence-Based Multicenter Cost-of-Illness Study.
Direct Medical Cost of Hospitalization for Acute Stroke in Lebanon: A Prospective Incidence-Based Multicenter Cost-of-Illness Study.
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DOI：
10.1177/0046958018792975
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发表时间：
2018-01
期刊：
影响因子：
--
通讯作者：
Hosseini HH
中科院分区：
文献类型：
--
作者：
Abdo RR;Abboud HM;Salameh PG;Jomaa NA;Rizk RG;Hosseini HH
中风是一个重大的社会和健康问题，给国民经济带来了沉重的负担。我们提供了黎巴嫩急性中风护理的直接住院费用的详细财务数据，并对其驱动因素进行了评估。这是一项观察性、定量、前瞻性、多中心、基于发病率、自下而上的疾病成本研究。分析了贝鲁特8家医院1年来收治的中风患者的医疗和账单记录。计算直接医疗成本，并使用多变量线性回归分析评估成本驱动因素。共纳入203例中风患者(男性：58%；平均年龄：68.8±12.9岁)。所有病例的直接住院费用为2626天1 413 069美元(每住院日538美元)。平均每位卒中患者的住院费用为6961美元±15663美元。出血性中风是代价最高的，短暂性脑缺血发作是代价最低的。成本驱动因素包括住院时间、重症监护病房住院时间、中风类型、中风严重程度、改良的Rankin量表、第三方付款人、手术和感染性并发症。急性中风护理的直接医疗费用给黎巴嫩卫生系统带来了沉重的财政负担。制定有针对性的公共卫生政策和初级预防活动需要优先考虑将未来的中风入院人数降至最低并控制这一成本。
Stroke is a major social and health problem posing heavy burden on national economies. We provided detailed financial data on the direct in-hospital cost of acute stroke care in Lebanon and evaluated its drivers. This was an observational, quantitative, prospective, multicenter, incidence-based, bottom-up cost-of-illness study. Medical and billing records of stroke patients admitted to 8 hospitals in Beirut over 1 year were analyzed. Direct medical costs were calculated, and cost drivers were assessed using a multivariable linear regression analysis. In total, 203 stroke patients were included (male: 58%; mean age: 68.8 ± 12.9 years). The direct in-hospital cost for all cases was US$1 413 069 for 2626 days (US$538 per in-hospital day). The average in-hospital cost per stroke patient was US$6961 ± 15 663. Hemorrhagic strokes were the most costly, transient ischemic attack being the least costly. Cost drivers were hospital length of stay, intensive care unit length of stay, type of stroke, stroke severity, modified Rankin Scale, third party payer, surgery, and infectious complications. Direct medical cost of acute stroke care represents high financial burden to Lebanese health system. Development of targeted public health policies and primary prevention activities need to take priority to minimize stroke admission in future and to contain this cost.
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