Effects of stroke on medical resource use and costs in acute myocardial infarction.
Background-Stroke occurs concurrently with myocardial infarction (MI) in 30 000 US patients each year.
This number is expected to rise with the increasing use of thrombolytic therapy for MI.
However, no data exist for the economic effect of stroke in the setting of acute MI (AMI).
The purpose of this prospective study was to assess the effect of stroke on medical resource use and costs in AMI patients in the United States.
Methods and Results-Medical resource use and cost data were prospectively collected for 2566 randomly selected US GUSTO I patients (from 23 105 patients) and for the 321 US GUSTO I patients who developed non-bypass surgery-related stroke during the baseline hospitalization.
Follow-up was for I year.
All costs are expressed in 1993 US dollars.
During the baseline hospitalization, stroke was associated with a reduction in cardiac procedure rates and an increase in length of stay, despite a hospital mortality rate of 37%. Together with stroke-related procedural costs of $2220 per patient, the baseline medical costs increased by 44% ($29 242 versus $20 301, P<0.0001).
Follow-up medical costs were substantially higher for stroke survivors ($22 400 versus $5282, P<0.0001), dominated by the cost of institutional care.
The main determinant for institutional care was discharge disability status.
The cumulative 1-year medical costs for stroke patients were $15 092 higher than for no-stroke patients. (...)
Mots-clés Pascal : Infarctus, Myocarde, Etats Unis, Amérique du Nord, Amérique, Accident cérébrovasculaire, Association morbide, Homme, Coût, Economie santé, Traitement, Exploration, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Infarct, Myocardium, United States, North America, America, Stroke, Concomitant disease, Human, Costs, Health economy, Treatment, Exploration, Cardiovascular disease, Coronary heart disease, Myocardial disease, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0120216
Code Inist : 002B12A03. Création : 16/11/1999.