Acute stroke care and rehabilitation : An analysis of the direct cost and its clinical and social determinants : The Copenhagen Stroke Study.
Background and Purpose Stroke represents a major economic challenge to society.
The direct cost of stroke is largely determined by the duration of hospital stay, but internationally applicable estimates of the direct cost of acute stroke care and rehabilitation on cost-efficient stroke units are not available.
Information regarding social and medical factors influencing the length of hospital stay (LOHS) and thereby cost is needed to direct cost-reducing efforts.
Methods We determined the direct cost of stroke in the prospective, consecutive, and community-based stroke population of the Copenhagen Stroke Study by measuring the total LOHS in the 1197 acute stroke patients included in the study.
All patients had all their acute care and rehabilitation on a dedicated stroke unit.
Neurological impairment was measured by the Scandinavian Stroke Scale.
Local nonmedical factors affecting the LOHS, such as waiting time for discharge to a nursing home after completed rehabilitation, were accounted for in the analysis.
The influence of social and medical factors on the LOHS was analyzed in a multiple linear regression model.
Results The average LOHS was 27.1 days (SD, 44.1 ; range, 1 to 193), corresponding to a direct cost of $12.150 per patient including all acute care and rehabilitation.
The LOHS increased with increasing stroke severity (6 days per 10-point increase in severity ; P<. 0001) and single marital status (3.4 days ; P=02).
Death reduced LOHS (22.0 days ; P<. 0001). (...)
Mots-clés Pascal : Accident cérébrovasculaire, Réhabilitation, Coût, Danemark, Europe, Traitement, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Economie santé
Mots-clés Pascal anglais : Stroke, Rehabilitation, Costs, Denmark, Europe, Treatment, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Cardiovascular disease, Vascular disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0337263
Code Inist : 002B17C. Création : 12/09/1997.