Cost of caring for stroke patients double that of earlier estimates

Jun 08, 2010

Health-care costs for patients in just the first six months after they have a stroke is more than $2.5 billion a year in Canada, according to a study presented today at the Canadian Stroke Congress.

The Canadian Network's Burden of (BURST) study found that the direct and indirect health-care costs for new stroke patients tally an average $50,000 in the six-month period following a new stroke. There are about 50,000 new strokes in Canada each year.

Earlier and widely quoted estimates, based on the most recent data from Health Canada's of Illness (1998), indicated that the total cost of stroke in Canada was $2.4 billion a year for both new stroke patients and long-term survivors. There are 300,000 people living with stroke in Canada.

"Our old estimates of how much stroke costs the economy are way off base," says Dr. Mike Sharma, who together with Dr. Nicole Mittmann of Sunnybrook Health Sciences Centre, led the BURST study, which is the first prospective national economic analysis on stroke costs.

"The cost of stroke is far more than we expected - at least double previous estimates."

BURST researchers examined the health-care costs of 232 hospitalized stroke patients in 12 sites across Canada at discharge, three months, six months, and one year. The study looked at both disabling and non-disabling stroke.

Hospitalization, medication, physician services, , homecare and rehabilitation all contribute to the bill. There are also indirect costs, including disability leave, lost wages, assisted devices, caregivers, and out-of-pocket expenses for families such as personal assistance products or changes to homes to accommodate disabilities.

While costs are much higher than expected, "the idea is to make initial investments in prevention and acute treatment to prevent these costs down the road," says Dr. Sharma.

For example, health-care costs fall sharply when people get access to the clot-busting drug tPA, which can significantly reduce post-stroke disability, as well as treatment in a specialized stroke unit.

Prevention is the biggest factor in reducing health-care spending overall, Dr. Sharma says. If people maintain a healthy blood pressure, maintain a healthy weight, reduce sodium intake, and exercise, the impact on stroke costs would be dramatic.

While at least 80 per cent of costs during the first six months post-stroke are health-system costs, families take on a greater proportion of stroke-related expenses, including those associated with caregiving, transportation, and lost income, beginning at the seventh month post-stroke and beyond.

Costs rise dramatically as levels of disability increase. People with non-disabling strokes - about 25 per cent of patients - personally expended about $2,000 in costs during the first six months. The costs for families increased from there to as much as $200,000 for the most severely affected.

"The difference between merely having symptoms to requiring even minimal at-home assistance from others can mean a significant cost difference," says Dr. Sharma. "The need to have someone drive you around and help with shopping can double personal costs - as well as costs incurred by the person helping you."

Dr. Sharma, who is director of the Ottawa Hospital's regional stroke program, says that personal costs for stroke survivors continue through their lifetimes. "It's a burden on individuals, their families, and communities."

"A stroke doesn't just affect one person − it has a ripple effect," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It can challenge families, overburden caregivers, and have a tremendous toll on our healthcare system."

Stroke is the third leading cause of death and a leading cause of disability. The situation may get worse, with aging baby boomers entering their at-risk years.

In 2011 the baby boom generation will enter the period of increasing risk for stroke. "After age 55, the stroke risk doubles every 10 years," says Dr. Hill. "This will increase the strain on our healthcare services."

Over the next two decades, the number of Canadians who are age 65 and over will grow from roughly 4.3 million today to 8 million. Their share of the population will rise from about 13 per cent today to more than 20 per cent, says Dr. Hill.

"We have to learn − and learn fast − how to respond to this situation," says Dr. Antoine Hakim, Canadian Stroke Network spokesperson.

Coordination is key. "Our objective for the study was to identify the cost drivers so decision makers can make informed choices," Dr. Sharma says.

Explore further: Saudi Arabia reports two more deaths from MERS virus

Provided by Heart and Stroke Foundation of Canada

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Study opens way for later treatment of acute stroke

Sep 15, 2008

The time span in which treatment should be given for acute ischaemic stroke – i.e. stroke caused by a clot or other obstruction to the blood supply – can be lengthened. This according to a study from the Swedish medical ...

Under 50? Silent duo could put you at risk for a big stroke

Jun 08, 2010

Being young doesn't mean you are immune to a stroke. You may feel healthy; you may be 18 or a vigorous 50. And yet you could be more vulnerable than you know. That could be because of the role played by silent risk factors ...

New study reveals the financial effects of stroke in China

May 07, 2009

A new study has found that families in China face considerable economic hardship following stroke, and it is not uncommon for health care costs to push families below the poverty line. The large study shows over 70% of stroke ...

Recommended for you

User comments : 0

More news stories

Fresh hope for preventing pneumonia in the elderly

There are calls for the frail and elderly not be be overlooked for vaccines against pneumonia this winter, with UNSW research challenging conventional wisdom on immunisation effectiveness in older patients.

Phase transiting to a new quantum universe

(Phys.org) —Recent insight and discovery of a new class of quantum transition opens the way for a whole new subfield of materials physics and quantum technologies.

Imaging turns a corner

(Phys.org) —Scientists have developed a new microscope which enables a dramatically improved view of biological cells.

NASA image: Volcanoes in Guatemala

This photo of volcanoes in Guatemala was taken from NASA's C-20A aircraft during a four-week Earth science radar imaging mission deployment over Central and South America. The conical volcano in the center ...

When things get glassy, molecules go fractal

Colorful church windows, beads on a necklace and many of our favorite plastics share something in common—they all belong to a state of matter known as glasses. School children learn the difference between ...