Population-based study of acute- and long-term care costs after stroke in patients with AF.
Summary of "Population-based study of acute- and long-term care costs after stroke in patients with AF."
BACKGROUND:
New treatments for atrial fibrillation patients have been shown to be effective at reducing subsequent vascular event recurrence. However, there are few data on stroke costs in atrial fibrillation patients to allow the cost-effectiveness of these treatments to be assessed.
AIMS:
Using data from a population-based study, we assessed the acute and long-term costs of stroke in atrial fibrillation patients.
METHODS:
Health-care costs one-year before and five-years after stroke were obtained from a large population-based study (Oxford Vascular study). Costs were assessed for the three-months poststroke (acute period) and annually thereafter (postacute period). Annual postacute costs were compared with annual baseline costs. Based on patients' living arrangements, costs of institutionalization after the event were included.
RESULTS:
A total of 191 strokes occurred in 153 patients with known prior atrial fibrillation. Mean health-care costs after stroke were £10 413 (standard deviation 15 105) in the acute phase, with annual postacute health-care costs nonsignificantly smaller than those incurred before the event (£2400 vs. £3356, respectively; P = 0·198). However, for the 136 strokes surviving past the 90-day acute period, costs were nonsignificantly higher than those incurred in the year before the event (£3370 vs. £2566, respectively; P = 0·333). After stroke, 25 (13%) patients were newly admitted into long-term warden, nursing, or residential care, resulting in annual costs of £6880 (standard deviation 15 600) averaged across the 136 stroke cases surviving past the acute period.
CONCLUSIONS:
Although annual post acute phase hospital and primary health-care costs in stroke patients with prior atrial fibrillation were not significantly different to those incurred before the stroke, long-term nursing/residential care costs were substantial.
Affiliation
Health Economics Research Centre, Department of Public Health, Old Road Campus, University of Oxford, Oxford, UK.
Journal Details
This article was published in the following journal.
Name: International journal of stroke : official journal of the International Stroke Society
ISSN: 1747-4949
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22568484
- DOI: http://dx.doi.org/10.1111/j.1747-4949.2012.00812.x
Medical and Biotech [MESH] Definitions
Insurance, Long-term Care
Health insurance to provide full or partial coverage for long-term home care services or for long-term nursing care provided in a residential facility such as a nursing home.
Bed Conversion
The reallocation of beds from one type of care service to another, as in converting acute care beds to long term care beds.
Subacute Care
Medical and skilled nursing services provided to patients who are not in an acute phase of an illness but who require a level of care higher than that provided in a long-term care setting. (JCAHO, Lexikon, 1994)
Progressive Patient Care
Organization of medical and nursing care according to the degree of illness and care requirements in the hospital. The elements are intensive care, intermediate care, self-care, long-term care, and organized home care.
Hospital Costs
The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).
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