Winter Y, Wolfram C, Schöffski O, Dodel R C, Back T
Neurologische Klinik, Philipps-Universität Marburg, Marburg.
Nervenarzt. 2008 Aug;79(8):918-20, 922-4, 926. doi: 10.1007/s00115-008-2505-3.
The economic burden of stroke is considerable. While studies on the costs of acute stroke treatment have been undertaken in Germany, thorough analysis of direct and indirect long-term costs is lacking.
A hospital-based cohort of 151 consecutive patients with stroke or transient ischemic attacks (TIA) was followed up (medical examination and interview) at the end of the 4th year following the cerebrovascular event. Costs were calculated using a bottom-up approach and classified into direct medical and nonmedical costs, indirect costs, and patients' costs.
Non-stroke-related costs (mean +/- standard deviation 4,610+/-9,310 Euros/person) were separated from total costs. Total stroke-related costs of the 4th year after stroke/TIA amounted to 7,670+/-10,250 Euros per person. The cost components were as follows: direct costs 56% (4,320+/-5,740 Euros), indirect costs 31% (2,350+/-2,710 Euros), and patients' payments 13% (1,000+/-4,100 Euros). The annual nationwide costs for the 4th year following stroke or TIA amounted to approximately 3 billion Euros.
The considerable size of long-term costs after stroke/TIA is mainly due to direct costs and poses an economic challenge to the German health care system. Patients contribute in a relevant way by their own payments.
中风的经济负担相当大。虽然德国已开展了关于急性中风治疗成本的研究，但缺乏对直接和间接长期成本的全面分析。
以医院为基础，对151例连续的中风或短暂性脑缺血发作（TIA）患者进行队列研究，在脑血管事件发生后的第4年末进行随访（医学检查和访谈）。成本采用自下而上的方法计算，并分为直接医疗和非医疗成本、间接成本以及患者成本。
将非中风相关成本（平均±标准差为4610±9310欧元/人）与总成本分开。中风/TIA后第4年的中风相关总成本为每人7670±10250欧元。成本构成如下：直接成本56%（4320±5740欧元），间接成本31%（2350±2710欧元），患者支付13%（1000±4100欧元）。中风或TIA后第4年全国范围内的年度成本约为30亿欧元。
中风/TIA后长期成本规模巨大，主要归因于直接成本，这给德国医疗保健系统带来了经济挑战。患者自身支付在其中占了相当比例。
