Lekander Ingrid, Willers Carl, von Euler Mia, Lilja Mikael, Sunnerhagen Katharina S, Pessah-Rasmussen Hélène, Borgström Fredrik
Ivbar Institute AB, Stockholm, Sweden.
Medical Management Center, LIME, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2017 Apr 6;12(4):e0174861. doi: 10.1371/journal.pone.0174861. eCollection 2017.
Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)).
Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS).
The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000-480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000-1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability.
Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke.
中风会影响死亡率、功能能力、生活质量并产生费用。本研究的主要目的是按残疾程度和中风类型（缺血性中风（IS）或出血性中风（ICH））估算瑞典中风护理的费用。
基于一个包含多个登记处关联数据的研究数据库，估算中风后第一年和第二年的资源使用情况。估算了中风急性和急性后期管理的费用，包括直接费用（医疗保健消耗和市政服务）和间接费用（生产力损失）。按中风类型和根据改良Rankin量表（mRS）分类的功能残疾情况估算资源和费用。
结果表明，中风后每位患者的平均费用为350,000瑞典克朗/37,000欧元至480,000瑞典克朗/50,000欧元，具体取决于中风类型以及是否处于中风后的第一年或第二年。在功能残疾和中风类型的不同亚组之间发现了很大差异，每位患者的年度费用从100,000瑞典克朗/10,000欧元至1,100,000瑞典克朗/120,000欧元不等，与缺血性中风相比，出血性中风患者的费用更高，且随着功能残疾程度加重费用增加。
功能结局是中风护理费用的主要决定因素。与较差结局相关的中风类型（ICH）也始终与较高费用相关。改善功能的措施不仅对个体患者及其家庭很重要，还可能减轻中风的社会负担。
