Predictors of Socioeconomic Burden and Cost-Effectiveness of Hospital Cares for Ischemic Stroke

Abstract

Background: Stroke as the most common cause of disability and the second common cause of death, has deleterious socio-economic impacts on the healthcare systems and societies worldwide. So we aimed to investigate stroke outcomes of Iranian patients in terms of human and hospital costs. Methods: In this study, patients admitted to Rasoul-e-Akram hospital, diagnosed with ischemic stroke were included. One month to 2 years telephone follow-up were applied. Cox proportional hazards regression analyses and Kaplan-Meier analysis were assigned for mortality and survival analyses, respectively. Economic predictors and cost-effectiveness of hospital cares were analyzed by T-test and Leven’s test. Results: Among 134 patients, in-hospital and long-term mortality rates were 7.46% and 4.03%, respectively and 985.5% of the patients survived for one month and 96.3% survived for 2 years. Mortality increased with age and initial pulse rate. The average of health-care system costs was estimated at 61.905$/day. The most proportion of total costs was attributed to the nursing services and bed-day costs. Medications were the second most costly cares. Cost-effectiveness analyses determined consultation and laboratory assessments as the significant cost-effective hospital cares. Conclusion: Specific preventive strategies are recommended for elderly people. As also, patients with high initial pulse rate should be considered as high-risk patients. This study suggests consultations and laboratories as the cost-effective cares in stroke management.