Ramamoorthy Venkataraghavan, Chan Kelvin, Roy Mukesh, Saxena Anshul, Ahmed Md Ashfaq, Zhang Zhenwei, Appunni Sandeep, Thomas Ronnie, McGranaghan Peter, McDermott Michael, La Rosa Felipe De Los Rios, Rubens Muni
Center for Advanced Analytics, Baptist Health South Florida, Miami, FL 33176, USA.
Nova Southeastern University, Fort Lauderdale, FL 33314, USA.
J Stroke Cerebrovasc Dis. 2023 Oct;32(10):107333. doi: 10.1016/j.jstrokecerebrovasdis.2023.107333. Epub 2023 Aug 31.
In the US, between 2018 and 2019, approximately $57 billion were expended on stroke and related conditions. The aim of this study was to understand trends in direct healthcare expenditures among stroke patients using novel cost estimation methods and a nationally representative database.
This study was a retrospective analysis of 193,003 adults, ≥18 years of age, using the Medical Expenditure Panel Survey during 2009-2016. Manning and Mullahy's two-part model were used to calculate adjusted mean and incremental medical expenditures after adjusting for covariates.
The mean (Standard Deviation) direct annual healthcare expenditure among stroke patients was $16,979.0 ($16,222.0- $17,736.0) and was nearly 3 times greater than non-stroke participants which were $5,039.7 ($4,951.0-$5,128.5) and were mainly spent on inpatient services, prescription medications, and office-based visits. Stroke patients had an additional healthcare expenditure of $4096.0 (3543.9, 4648.1) per person per year, compared to participants without stroke after adjusting for covariates (P<0.001). The total mean annual direct healthcare expenditure for stroke survivors increased from $16,142.0 (15,017.0-17,267.0) in 2007-2008 to $16,979.0 (16,222.0-17,736.0) in 2015-2016.
Our study showed that stroke survivors had significantly greater healthcare expenses, compared to non-stroke individuals, mainly due to higher expenditures on inpatient services, prescription drugs, and office visits. These findings are concerning because the prevalence of stroke is projected to increase due to aging population and increased survival rates.
在美国，2018年至2019年期间，中风及相关疾病的支出约为570亿美元。本研究的目的是使用新颖的成本估算方法和具有全国代表性的数据库，了解中风患者直接医疗保健支出的趋势。
本研究对2009年至2016年期间年龄≥18岁的193,003名成年人进行了回顾性分析，使用医疗支出面板调查。在对协变量进行调整后，使用曼宁和穆拉希的两部分模型来计算调整后的平均和增量医疗支出。
中风患者的平均（标准差）年度直接医疗保健支出为16,979.0美元（16,222.0 - 17,736.0美元），几乎是非中风参与者的3倍，后者为5,039.7美元（4,951.0 - 5,128.5美元），主要用于住院服务、处方药和门诊就诊。在对协变量进行调整后，与非中风参与者相比，中风患者每人每年的额外医疗保健支出为4096.0美元（3543.9, 4648.1美元）（P<0.001）。中风幸存者的年度直接医疗保健总平均支出从2007 - 2008年的16,142.0美元（15,017.0 - 17,267.0美元）增加到2015 - 2016年的16,979.0美元（16,222.0 - 17,736.0美元）。
我们的研究表明，与非中风个体相比，中风幸存者的医疗保健费用显著更高，主要是由于住院服务、处方药和门诊就诊的支出更高。这些发现令人担忧，因为由于人口老龄化和生存率提高，预计中风的患病率将会增加。
