TY - JOUR
T1 - Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation
T2 - Population-based study
AU - Hannon, Niamh
AU - Daly, Leslie
AU - Murphy, Sean
AU - Smith, Samantha
AU - Hayden, Derek
AU - Chróinín, Danielle Ní
AU - Callaly, Elizabeth
AU - Horgan, Gillian
AU - Sheehan, Órla
AU - Honari, Bahman
AU - Duggan, Joseph
AU - Kyne, Lorraine
AU - Dolan, Eamon
AU - Williams, David
AU - Wiley, Miriam
AU - Kelly, Peter J.
N1 - Publisher Copyright:
© 2014 American Heart Association, Inc.
PY - 2014/12/11
Y1 - 2014/12/11
N2 - Background and Purpose - No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.Methods - In a population-based prospective study of incident and recurrent stroke treated in hospital and community settings, we investigated direct (healthcare related) and indirect costs for a 2-year period. Survival, disability, poststroke residence, and healthcare use were determined at 90 days, 1 year, and 2 years. Acute hospital cost was determined using a case-mix approach, and other costs using a bottom-up approach (2007 prices).Results - In 568 patients ascertained in 1 year (2006), the total estimated 2-year cost was $33.84 million. In the overall sample, AF-stroke accounted for 31% (177) of patients, but a higher proportion of costs (40.5% of total and 45% of nursing home costs). On a per-patient basis compared with non-AF-stroke, AF-stroke was associated with higher total (P<0.001) and acute hospital costs (P<0.001), and greater nursing home (P=0.001) and general practitioner (P<0.001) costs among 90-day survivors. After stratification by stroke severity in survivors, AF was associated with 2-fold increase in costs in patients with mild-moderate (National Institutes of Health Stroke Scale, 0-15) stroke (P<0.001) but not in severe stroke (National Institutes of Health Stroke Scale =16; P=0.7).Conclusions - In our population study, AF-stroke was associated with substantially higher total, acute hospital, nursing home, and general practitioner costs per patient. Targeted programs to identify AF and prevent AF-stroke may have significant economic benefits, in addition to health benefits.
AB - Background and Purpose - No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.Methods - In a population-based prospective study of incident and recurrent stroke treated in hospital and community settings, we investigated direct (healthcare related) and indirect costs for a 2-year period. Survival, disability, poststroke residence, and healthcare use were determined at 90 days, 1 year, and 2 years. Acute hospital cost was determined using a case-mix approach, and other costs using a bottom-up approach (2007 prices).Results - In 568 patients ascertained in 1 year (2006), the total estimated 2-year cost was $33.84 million. In the overall sample, AF-stroke accounted for 31% (177) of patients, but a higher proportion of costs (40.5% of total and 45% of nursing home costs). On a per-patient basis compared with non-AF-stroke, AF-stroke was associated with higher total (P<0.001) and acute hospital costs (P<0.001), and greater nursing home (P=0.001) and general practitioner (P<0.001) costs among 90-day survivors. After stratification by stroke severity in survivors, AF was associated with 2-fold increase in costs in patients with mild-moderate (National Institutes of Health Stroke Scale, 0-15) stroke (P<0.001) but not in severe stroke (National Institutes of Health Stroke Scale =16; P=0.7).Conclusions - In our population study, AF-stroke was associated with substantially higher total, acute hospital, nursing home, and general practitioner costs per patient. Targeted programs to identify AF and prevent AF-stroke may have significant economic benefits, in addition to health benefits.
KW - Atrial fibrillation
KW - Healthcare economics and organizations
KW - Prevention and control
KW - Stroke
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U2 - 10.1161/STROKEAHA.114.005960
DO - 10.1161/STROKEAHA.114.005960
M3 - Article
C2 - 25358697
AN - SCOPUS:84922481000
SN - 0039-2499
VL - 45
SP - 3670
EP - 3674
JO - Stroke
JF - Stroke
IS - 12
ER -