Strilciuc Stefan, Grad Diana Alecsandra, Mixich Vlad, Stan Adina, Buzoianu Anca Dana, Vladescu Cristian, Vintan Mihaela Adela
Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, 4000012 Cluj-Napoca, Cluj, Romania.
RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400354 Cluj-Napoca, Cluj, Romania.
Brain Sci. 2021 May 24;11(6):689. doi: 10.3390/brainsci11060689.
Health policies in transitioning health systems are rarely informed by the economic burden of disease due to scanty access to data. This study aimed to estimate direct and indirect costs for first-ever acute ischemic stroke (AIS) during the first year for patients residing in Cluj, Romania, and hospitalized in 2019 at the County Emergency Hospital (CEH).
The study was conducted using a mixed, retrospective costing methodology from a societal perspective to measure the cost of first-ever AIS in the first year after onset. Patient pathways for AIS were reconstructed to aid in mapping inpatient and outpatient cost items. We used anonymized administrative and clinical data at the hospital level and publicly available databases.
The average cost per patient in the first year after stroke onset was RON 25,297.83 (EUR 5226.82), out of which 80.87% were direct costs. The total cost in Cluj, Romania in 2019 was RON 17,455,502.7 (EUR 3,606,505.8).
Our costing exercise uncovered shortcomings of stroke management in Romania, particularly related to acute care and neurorehabilitation service provision. Romania spends significantly less on healthcare than other countries (5.5% of GDP vs. 9.8% European Union average), exposing stroke survivors to a disproportionately high risk for preventable and treatable post-stroke disability.
由于获取数据的机会有限，转型期卫生系统中的卫生政策很少考虑疾病的经济负担。本研究旨在估算罗马尼亚克卢日县2019年在县急救医院（CEH）住院的首次发生急性缺血性卒中（AIS）患者第一年的直接和间接成本。
本研究采用混合回顾性成本核算方法，从社会角度衡量首次发生AIS发病后第一年的成本。重建AIS患者的就医路径，以帮助确定住院和门诊成本项目。我们使用了医院层面的匿名行政和临床数据以及公开可用的数据库。
卒中发病后第一年每位患者的平均成本为25,297.83罗马尼亚列伊（5226.82欧元），其中80.87%为直接成本。2019年罗马尼亚克卢日县的总成本为17,455,502.7罗马尼亚列伊（3,606,505.8欧元）。
我们的成本核算揭示了罗马尼亚卒中管理的不足，特别是在急性护理和神经康复服务提供方面。罗马尼亚在医疗保健方面的支出明显低于其他国家（占国内生产总值的5.5%，而欧盟平均水平为9.8%），这使卒中幸存者面临可预防和可治疗的卒中后残疾的高风险。
