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COSTS FOR STROKE IN SWEDEN 2009 AND DEVELOPMENTS SINCE 1997

Published online by Cambridge University Press:  04 June 2014

Ola Ghatnekar
Affiliation:
Department of Public Health and Clinical Medicine, Umeå University
Ulf Persson
Affiliation:
Swedish Institute for Health Economics
Kjell Asplund
Affiliation:
Department of Public Health and Clinical Medicine, Umeå University
Eva-Lotta Glader
Affiliation:
Department of Public Health and Clinical Medicine, Umeå University

Abstract

Objectives: The aim of this study was to estimate direct and indirect excess costs attributable to stroke in Sweden in 2009 and to compare these with similar estimates from 1997.

Methods: Data on first-ever stoke admissions in the first half of 2009 from the Swedish national stroke register (RS) were used for cost calculations and compared with results from 1997 also using RS data. A societal perspective was taken including the acute and follow-up phase, rehabilitation, stroke re-admissions, drugs, home- and residential care services for activities of daily life (ADL) support, and indirect costs for premature death and productivity losses (2009 prices). Survival was extrapolated to estimate the lifetime present value cost of stroke.

Results: The societal lifetime present value cost for stroke in 2009 was €68,800 per patient (ADL support: 59 percent; productivity losses: 21 percent). Women had higher costs than men in all age groups as a result from greater need for ADL support. Patients treated at a stroke unit indicated low incremental cost per life-year gained compared with those who had not. The total lifetime cost increased between 1997 and 2009. Hospitalization costs per patient were stable, while long-term costs for home- and residential care services increased.

Conclusions: Changes in patient characteristics, longer expected survival, and possibly in the Swedish stroke care, have led to higher annual and lifetime costs per patient in 2009 compared with 1997. A comprehensive national stroke care performance register like RS may be suitable for health economic assessments.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

1. Gustavsson, A, Svensson, M, Jacobi, F, et al. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21:718779.CrossRefGoogle ScholarPubMed
2. Ghatnekar, O, Persson, U, Glader, EL, et al. Cost of stroke in Sweden: An incidence estimate. Int J Technol Assess Health Care. 2004;20:375380.CrossRefGoogle ScholarPubMed
3. Persson, J, Ferraz-Nunes, J, Karlberg, I. Economic burden of stroke in a large county in Sweden. BMC Health Serv Res. 2012;12:341.CrossRefGoogle Scholar
4. National Board of Health and Welfare. National guidelines for stroke care - Summary. http://www.socialstyrelsen.se/nationalguidelines/nationalguidelinesforstrokecare (accessed March 26, 2013).Google Scholar
5. Asplund, K, Hulter Asberg, K, Appelros, P, et al. The Riks-Stroke story: Building a sustainable national register for quality assessment of stroke care. Int J Stroke. 2011;6:99108.CrossRefGoogle ScholarPubMed
6. Riks-Stroke. Annual report 2011 summary. http://www.riks-stroke.org/content/analyser/Riks-Strokes_report_2011-English.pdf (accessed March 26, 2013).Google Scholar
7. Appelros, P, Jonsson, F, Asplund, K, et al. Trends in baseline patient characteristics during the years 1995–2008: Observations from Riks-Stroke, the Swedish Stroke Register. Cerebrovasc Dis. 2010;30:114119.CrossRefGoogle ScholarPubMed
8. Asplund, K, Glader, EL, Norrving, B, et al. Effects of extending the time window of thrombolysis to 4.5 hours: Observations in the Swedish stroke register (riks-stroke). Stroke. 2011;42:24922497.CrossRefGoogle ScholarPubMed
9. Eriksson, M, Jonsson, F, Appelros, P, et al., Dissemination of thrombolysis for acute ischemic stroke across a nation: Experiences from the Swedish stroke register, 2003 to 2008. Stroke. 2010;41:11151122.CrossRefGoogle ScholarPubMed
10. Stecksen, A, Asplund, K, Appelros, P, et al. Thrombolytic therapy rates and stroke severity: An analysis of data from the Swedish stroke register (Riks-Stroke) 2007–2010. Stroke. 2012;43:536538.CrossRefGoogle ScholarPubMed
11. Sjolander, M, Eriksson, M, Glader, EL. Social stratification in the dissemination of statins after stroke in Sweden. Eur J Clin Pharmacol. 2013;69:11731180.CrossRefGoogle ScholarPubMed
12. Terent, A, Asplund, K, Farahmand, B, et al. Stroke unit care revisited: Who benefits the most? A cohort study of 105,043 patients in Riks-Stroke, the Swedish Stroke Register. J Neurol Neurosurg Psychiatry. 2009;80:881887.CrossRefGoogle ScholarPubMed
13. Swedish Association of Local Authorities and Regions. KPP-databasen. https://stat2.skl.se/kpp/index.htm (accessed March 26, 2013).Google Scholar
14. Bjorkdahl, A, Nilsson, AL, Grimby, G, et al. Does a short period of rehabilitation in the home setting facilitate functioning after stroke? A randomized controlled trial. Clin Rehab. 2006;20:10381049.CrossRefGoogle Scholar
15. Swedish Association of Local Authorities and Regions. Vad kostar verksamheten i Din kommun? Bokslut 2009, 2010. Stockholm: WebOr-gruppen:.Google Scholar
16. Swedish Association of Local Authorities and Regions. Kostnad per brukare. Resultat och jämförelser inom omsorg om äldre och personer med funktionsnedsättning - utfall 2009, 2010, forsbergvonessen: Enskede.Google Scholar
17. Swedish Association of Local Authorities and Regions. Landstingsprisindex (LPI). http://www.skl.se/vi_arbetar_med/ekonomi/budget_och_planering/prisindex/landstingsprisindex (accessed March 26, 2013).Google Scholar
18. Riks-Stroke. Årsrapport 2009 [Annual report 2009; in Swedish], 2010: Umeå, Västerbotten läns landsting.Google Scholar
19. Rostgaard, T, Szebehely, M. Changing policies, changing patterns of care: Danish and Swedish home care at the crossroads. Eur J Ageing. 2012;9:101109.CrossRefGoogle ScholarPubMed
20. Towse, A, Garrison, LP, Jr. Can't get no satisfaction? Will pay for performance help?: toward an economic framework for understanding performance-based risk-sharing agreements for innovative medical products. Pharmacoeconomics. 2010;28:93102.CrossRefGoogle ScholarPubMed
21. Drummond, M, Jonsson, B. Moving beyond the drug budget silo mentality in Europe. Value Health. 2003;6(Suppl 1):S74S77.CrossRefGoogle ScholarPubMed
22. Ramsberg, J, Ekelund, M. Stuprörstänkande gör samhällets kostnader för ohälsa onödigt höga. Ekon Debatt. 2011;5:4153.Google Scholar
23. Glader, EL, Sjolander, M, Eriksson, M, et al. Persistent use of secondary preventive drugs declines rapidly during the first 2 years after stroke. Stroke. 2010;41:397401.CrossRefGoogle ScholarPubMed
24. Drummond, M, Barbieri, M, Cook, J, et al. Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report. Value Health. 2009;12:409418.CrossRefGoogle ScholarPubMed
25. Peltola, M, Quentin, W. Diagnosis-related groups for stroke in europe: Patient classification and hospital reimbursement in 11 countries. Cerebrovasc dis. 2013;35:113123.CrossRefGoogle ScholarPubMed