Abdo Rachel R, Abboud Halim M, Salameh Pascale G, Jomaa Najo A, Rizk Rana G, Hosseini Hassan H
1 Lebanese University, Beirut, Lebanon.
2 Paris-Est University, Creteil, France.
Inquiry. 2018 Jan-Dec;55:46958018792975. doi: 10.1177/0046958018792975.
Stroke is a major social and health problem posing heavy burden on national economies. We provided detailed financial data on the direct in-hospital cost of acute stroke care in Lebanon and evaluated its drivers. This was an observational, quantitative, prospective, multicenter, incidence-based, bottom-up cost-of-illness study. Medical and billing records of stroke patients admitted to 8 hospitals in Beirut over 1 year were analyzed. Direct medical costs were calculated, and cost drivers were assessed using a multivariable linear regression analysis. In total, 203 stroke patients were included (male: 58%; mean age: 68.8 ± 12.9 years). The direct in-hospital cost for all cases was US$1 413 069 for 2626 days (US$538 per in-hospital day). The average in-hospital cost per stroke patient was US$6961 ± 15 663. Hemorrhagic strokes were the most costly, transient ischemic attack being the least costly. Cost drivers were hospital length of stay, intensive care unit length of stay, type of stroke, stroke severity, modified Rankin Scale, third party payer, surgery, and infectious complications. Direct medical cost of acute stroke care represents high financial burden to Lebanese health system. Development of targeted public health policies and primary prevention activities need to take priority to minimize stroke admission in future and to contain this cost.
中风是一个重大的社会和健康问题，给各国经济带来沉重负担。我们提供了黎巴嫩急性中风护理住院直接费用的详细财务数据，并评估了其驱动因素。这是一项观察性、定量、前瞻性、多中心、基于发病率的自下而上的疾病成本研究。对贝鲁特8家医院1年内收治的中风患者的医疗和计费记录进行了分析。计算直接医疗费用，并使用多变量线性回归分析评估成本驱动因素。总共纳入了203例中风患者（男性：58%；平均年龄：68.8±12.9岁）。所有病例2626天的住院直接费用为1413069美元（每天住院费用538美元）。每位中风患者的平均住院费用为6961±15663美元。出血性中风费用最高，短暂性脑缺血发作费用最低。成本驱动因素包括住院时间、重症监护病房住院时间、中风类型、中风严重程度、改良Rankin量表、第三方支付者、手术和感染并发症。急性中风护理的直接医疗费用给黎巴嫩卫生系统带来了沉重的经济负担。制定有针对性的公共卫生政策和初级预防活动需要优先考虑，以尽量减少未来中风的入院人数并控制这一成本。
