Background and Purpose-We sought to determine predictors of acute hospital costs in patients presenting with acute ischemic stroke to an academic center using a stroke management team to coordinate care.
Methods-Demographic and clinical data were prospectively collected on 191 patients consecutively admitted with acute ischemic stroke.
Patients were classified by insurance status, premorbid modified Rankin scale, stroke location, stroke severity (National Institutes of Health Stroke Scale score), and presence of comorbidities.
Detailed hospital charge data were converted to cost by application of department-specific cost-to-charge ratios.
Physician's fees were not included.
A stepwise multiple regression analysis was computed to determine the predictors of total hospital cost.
Median length of stay was 6 days (range, 1 to 63 days), and mortality was 3%. Median hospital cost per discharge was $4408 (range, $1199 to $59 799).
Fifty percent of costs were for room charges, 19% for stroke evaluation, 21% for medical management, and 7% for acute rehabilitation therapies.
Sixteen percent were admitted to an intensive care unit.
Length of stay accounted for 43% of the variance in total cost.
Other independent predictors of cost included stroke severity, heparin treatment, atrial fibrillation, male sex, ischemic cardiac disease, and premorbid functional status. (...)
Mots-clés Pascal : Accident cérébrovasculaire, Ischémie, Coût moyen, Hospitalisation, Etats Unis, Amérique du Nord, Amérique, Analyse coût, Economie santé, Facteur prédictif, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Stroke, Ischemia, Average cost, Hospitalization, United States, North America, America, Cost analysis, Health economy, Predictive factor, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Cardiovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0213407
Code Inist : 002B17C. Création : 16/11/1999.