Abebe Tamrat Befekadu, Ilomaki Jenni, Livori Adam, Bell J Simon, Morton Jedidiah I, Ademi Zanfina
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia,
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
Neuroepidemiology. 2024;58(5):358-368. doi: 10.1159/000538564. Epub 2024 Apr 1.
Stroke remains one of the leading causes of morbidity and mortality in Australia. The objective of this study was to estimate the current and future cost burden of ischemic stroke (IS) in Australia.
First, the annual chronic management cost per person following IS were derived for all people aged ≥30 years discharged from a public or private hospital in Victoria, Australia between July 2012 and June 2017 (with follow-up data until June 2018 [n = 34,471]). Then extrapolated the data from from Victoria to the whole Australian population aged between 30 years and 99 years to project the total healthcare costs following IS (combination of acute event and chronic management cost) over a 20-year period (2019-2038) using a dynamic multistate life table model. Data for the dynamic model were sourced from the Victorian Admitted Episodes Dataset (VAED) and supplemented with other published data.
The estimated annual total chronic management cost following IS was 13,525 Australian dollars (AUD) per person (95% CI: AUD 13,380, AUD 13,670) for cohorts in the VAED between July 2012 and June 2017. The annual chronic management cost was estimated to decline following IS. The highest cost was incurred in the first year of follow-up post-IS (AUD 14,309 per person) and declined to AUD 9,776 in the sixth year of follow-up post-IS. The total healthcare cost for people aged 30-99 years was projected to be AUD 47.7 billion (95% UI: AUD 44.6 billion, AUD 51.0 billion) over the 20-year period (2019-2038) Australia-wide, of which 91.3% (AUD 43.6 billion) was attributed to chronic management costs and the remaining 8.7% (AUD 4.2 billion) were due to acute IS events.
IS has and will continue to have a considerable financial impact in the next 2 decades on the Australian healthcare system. Our estimated and projected cost burden following IS provides important information for decision making in relation to IS.
在澳大利亚，中风仍然是发病和死亡的主要原因之一。本研究的目的是估计澳大利亚缺血性中风（IS）当前和未来的成本负担。
首先，计算2012年7月至2017年6月期间从澳大利亚维多利亚州的公立或私立医院出院的所有30岁及以上人群在缺血性中风后的人均年度慢性管理成本（随访数据截至2018年6月[n = 34,471]）。然后，使用动态多状态生命表模型，将维多利亚州的数据外推至全澳大利亚30岁至99岁的人群，以预测20年期间（2019 - 2038年）缺血性中风后的总医疗成本（急性事件和慢性管理成本之和）。动态模型的数据来源于维多利亚州住院病例数据集（VAED），并辅以其他已发表的数据。
2012年7月至2017年期间，VAED队列中缺血性中风后的估计年度慢性管理总成本为每人13,525澳元（95%置信区间：13,380澳元，13,670澳元）。缺血性中风后的年度慢性管理成本估计呈下降趋势。缺血性中风后随访的第一年成本最高（每人14,309澳元），在随访的第六年降至9,776澳元。预计在20年期间（2019 - 2038年），全澳大利亚30 - 99岁人群的总医疗成本将达到477亿澳元（95%不确定区间：446亿澳元，510亿澳元），其中91.3%（436亿澳元）归因于慢性管理成本，其余8.7%（42亿澳元）归因于急性缺血性中风事件。
缺血性中风已经并将在未来20年继续对澳大利亚医疗系统产生重大财务影响。我们对缺血性中风后的估计和预测成本负担为缺血性中风相关决策提供了重要信息。
