Attributable Costs of Stroke in Ontario, Canada and Their Variation by Stroke Type and Social Determinants of Health.
Stroke
; 54(11): 2824-2831, 2023 11.
Article
en En
| MEDLINE
| ID: mdl-37823307
ABSTRACT
BACKGROUND:
Estimates of attributable costs of stroke are scarce, as most prior studies do not account for the baseline health care costs in people at risk of stroke. We estimated the attributable costs of stroke in a universal health care setting and their variation across stroke types and several social determinants of health.METHODS:
We undertook a population-based administrative database-derived matched retrospective cohort study in Ontario, Canada. Community-dwelling adults aged ≥40 years with a stroke between 2003 and 2018 were matched (11) on demographics and comorbidities with controls without stroke. Using a difference-in-differences approach, we estimated the mean 1-year direct health care costs attributable to stroke from a public health care payer perspective, accounting for censoring with a weighted available sample estimator. We described health sector-specific costs and reported variation across stroke type and social determinants of health.RESULTS:
The mean 1-year attributable costs of stroke were Canadian dollars 33â 522 (95% CI, $33â 231-$33â 813), with higher costs for intracerebral hemorrhage ($40â 244; $39â 193-$41â 294) than ischemic stroke ($32â 547; $32â 252-$32â 843). Most of these costs were incurred in acute care hospitals ($15â 693) and rehabilitation facilities ($7215). Compared with all patients with stroke, the mean attributable costs were higher among immigrants ($40â 554; $39â 316-$41â 793), those aged <65 years ($35â 175; $34â 533-$35â 818), and those residing in low-income neighborhoods ($34â 687; $34â 054-$35â 320) and lower among rural residents ($29â 047; $28â 362-$29â 731).CONCLUSIONS:
Our findings of high attributable costs of stroke, especially in immigrants, younger patients, and residents of low-income neighborhoods, can be used to evaluate potential health care cost savings associated with different primary stroke prevention strategies.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Determinantes Sociales de la Salud
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Año:
2023
Tipo del documento:
Article