Unveiling the evolving landscape of stroke care costs: A time-driven analysis

J Stroke Cerebrovasc Dis. 2024 Jun;33(6):107663. doi: 10.1016/j.jstrokecerebrovasdis.2024.107663. Epub 2024 Mar 1.

Abstract

Introduction: Stroke is a common cause of mortality in the United States. However, the economic burden of stroke on the healthcare system is not well known. In this study, we aim to calculate the annual cumulative and per-patient cost of stroke.

Methods: We conducted a retrospective analysis of Nationwide Emergency Department Sample (NEDS). We calculate annual trends in cost for stroke patients from 2006 to 2019. A multivariate linear regression with patient characteristics (e.g. age, sex, Charlson Comorbidity Index) as covariates was used to identify factors for higher costs.

Results: In this study time-period, 2,998,237 stroke patients presented to the ED and 2,481,171 (83 %) were admitted. From 2006 to 2019, the cumulative ED cost increased by a factor of 7.0 from 0.49 ± 0.03 to 3.91 ± 0.16 billion dollars (p < 0.001). The cumulative inpatient (IP) cost increased by a factor of 2.7 from 14.42 ± 0.78 to 37.06 ± 2.26 billion dollars (p < 0.001. Per-patient ED charges increased by a factor of 3.0 from 1950 ± 64 to 7818 ± 260 dollars (p < 0.001). Per-patient IP charges increased by 89 % from 40.22 +/- 1.12 to 76.06 ± 3.18 thousand dollars (p < 0.001).

Conclusion: Strokes place an increasing financial burden on the US healthcare system. Certain patient demographics including age, male gender, more comorbidities, and insurance type were significantly associated with increased cost of care.

Keywords: Cost; Epidemiology; Risk factors; Stroke.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Databases, Factual*
  • Emergency Service, Hospital* / economics
  • Female
  • Hospital Charges / trends
  • Hospital Costs* / trends
  • Humans
  • Male
  • Middle Aged
  • Patient Admission / economics
  • Patient Admission / trends
  • Retrospective Studies
  • Stroke* / diagnosis
  • Stroke* / economics
  • Stroke* / mortality
  • Stroke* / therapy
  • Time Factors
  • United States