Dewey Helen M, Thrift Amanda G, Mihalopoulos Cathy, Carter Robert, Macdonell Richard A L, McNeil John J, Donnan Geoffrey A
National Stroke Research Institute, Level 1, Neurosciences Bldg, Repatriation Campus, Austin & Repatriation Medical Centre, 300 Waterdale Rd, Heidelberg Heights, Victoria 3081, Australia.
Stroke. 2003 Oct;34(10):2502-7. doi: 10.1161/01.STR.0000091395.85357.09. Epub 2003 Sep 11.
Little is known about any variations in resource use and costs of care between stroke subtypes, especially nonhospital costs. The purpose of this study was to describe the patterns of resource use and to estimate the first-year and lifetime costs for stroke subtypes.
A cost-of-illness model was used to estimate the total first-year costs and lifetime costs of stroke subtypes for all strokes (subarachnoid hemorrhages excluded) that occurred in Australia during 1997. For each subtype, average cost per case during the first year and the present value of average cost per case over a lifetime were calculated. Resource use data obtained in the North East Melbourne Stroke Incidence Study (NEMESIS) were used.
The present value of total lifetime costs for all strokes was Aus 1.3 billion dollars (US 985 million dollars). Total lifetime costs were greatest for ischemic stroke (72%; Aus 936.8 million dollars; US 709.7 million dollars), followed by intracerebral hemorrhage (26%; Aus 334.5 million dollars; US 253.4 million dollars) and unclassified stroke (2%; Aus 30 million dollars; US 22.7 million dollars). The average cost per case during the first year was greatest for total anterior circulation infarction (Aus 28 266 dollars). Over a lifetime, the present value of average costs was greatest for intracerebral hemorrhage (Aus 73 542 dollars), followed by total anterior circulation infarction (Aus 53 020 dollars), partial anterior circulation infarction (Aus 50 692 dollars), posterior circulation infarction (Aus 37 270 dollars), lacunar infarction (Aus 34 470 dollars), and unclassified stroke (Aus 12 031 dollars).
First-year and lifetime costs vary considerably between stroke subtypes. Variation in average length of total hospital stay is the main explanation for differences in first-year costs.
关于不同类型中风在资源利用和护理成本方面的差异，尤其是非医院成本方面，人们了解甚少。本研究旨在描述资源利用模式，并估算不同类型中风的首年成本和终生成本。
采用疾病成本模型估算1997年在澳大利亚发生的所有中风（不包括蛛网膜下腔出血）不同类型的首年总成本和终生成本。对于每种类型，计算了首年每例的平均成本以及终生每例平均成本的现值。使用了在墨尔本东北部中风发病率研究（NEMESIS）中获得的资源利用数据。
所有中风终生成本的现值为13亿澳元（9.85亿美元）。缺血性中风的终生总成本最高（72%；9.368亿澳元；7.097亿美元），其次是脑出血（26%；3.345亿澳元；2.534亿美元）和未分类中风（2%；3000万澳元；2270万美元）。首年每例平均成本最高的是完全前循环梗死（28266澳元）。在一生中，平均成本现值最高的是脑出血（73542澳元），其次是完全前循环梗死（53020澳元）、部分前循环梗死（50692澳元）、后循环梗死（37270澳元）、腔隙性梗死（34470澳元）和未分类中风（12031澳元）。
不同类型中风的首年成本和终生成本差异很大。总住院时间平均长度的差异是首年成本差异的主要原因。
