The cost of stroke in a public hospital in Brazil: a one-year prospective study
ABSTRACT Low- and middle-income countries face tight health care budgets, not only new resources, but also costly therapeutic resources for treatment of ischemic stroke (IS). However, few prospective data about stroke costs including cerebral reperfusion from low- and middle-income countries are ava...
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| Format: | Article |
| Language: | English |
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Academia Brasileira de Neurologia (ABNEURO)
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000600404&lng=en&tlng=en |
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| author | Juliana SAFANELLI Luana Gabriela Dalla Rosa VIEIRA Tainá de ARAUJO Lidiana Fachinete Silva MANCHOPE Maria Helena Ribeiro KUHLHOFF Vivian NAGEL Adriana Bastos CONFORTO Gisele Sampaio SILVA Suleimy MAZIN Pedro Silva Corrêa de MAGALHÃES Norberto Luiz CABRAL |
| author_facet | Juliana SAFANELLI Luana Gabriela Dalla Rosa VIEIRA Tainá de ARAUJO Lidiana Fachinete Silva MANCHOPE Maria Helena Ribeiro KUHLHOFF Vivian NAGEL Adriana Bastos CONFORTO Gisele Sampaio SILVA Suleimy MAZIN Pedro Silva Corrêa de MAGALHÃES Norberto Luiz CABRAL |
| author_sort | Juliana SAFANELLI |
| collection | DOAJ |
| description | ABSTRACT Low- and middle-income countries face tight health care budgets, not only new resources, but also costly therapeutic resources for treatment of ischemic stroke (IS). However, few prospective data about stroke costs including cerebral reperfusion from low- and middle-income countries are available. Objective To measure the costs of stroke care in a public hospital in Joinville, Brazil. Methods We prospectively assessed all medical and nonmedical costs of inpatients admitted with a diagnosis of any stroke or transient ischemic attack over one year, analyzed costs per type of stroke and treatment, length of stay (LOS) and compared hospital costs with government reimbursement. Results We evaluated 274 patients. The total cost for the year was US$1,307,114; the government reimbursed the hospital US$1,095,118. We found a significant linear correlation between LOS and costs (r = 0.71). The median cost of 134 IS inpatients who did not undergo cerebral reperfusion (National Institutes of Health Stroke Scale [NIHSS] median = 3 ) was US$2,803; for IS patients who underwent intravenous (IV) alteplase (NIHSS 10), the median was US$5,099, and for IS patients who underwent IV plus an intra-arterial (IA) thrombectomy (NIHSS > 10), the median cost was US$10,997. The median costs of a primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack were US$2,436, US$8,031 and US$2,677, respectively. Conclusions Reperfusion treatments were two-to-four times more expensive than conservative treatment. A cost-effectiveness study of the IS treatment option is necessary. |
| first_indexed | 2024-12-20T19:36:37Z |
| format | Article |
| id | doaj.art-c68c8f5319f547c1936049f7ed3392e4 |
| institution | Directory Open Access Journal |
| issn | 1678-4227 |
| language | English |
| last_indexed | 2024-12-20T19:36:37Z |
| publisher | Academia Brasileira de Neurologia (ABNEURO) |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj.art-c68c8f5319f547c1936049f7ed3392e42022-12-21T19:28:39ZengAcademia Brasileira de Neurologia (ABNEURO)Arquivos de Neuro-Psiquiatria1678-422777640441110.1590/0004-282x20190059S0004-282X2019000600404The cost of stroke in a public hospital in Brazil: a one-year prospective studyJuliana SAFANELLILuana Gabriela Dalla Rosa VIEIRATainá de ARAUJOLidiana Fachinete Silva MANCHOPEMaria Helena Ribeiro KUHLHOFFVivian NAGELAdriana Bastos CONFORTOGisele Sampaio SILVASuleimy MAZINPedro Silva Corrêa de MAGALHÃESNorberto Luiz CABRALABSTRACT Low- and middle-income countries face tight health care budgets, not only new resources, but also costly therapeutic resources for treatment of ischemic stroke (IS). However, few prospective data about stroke costs including cerebral reperfusion from low- and middle-income countries are available. Objective To measure the costs of stroke care in a public hospital in Joinville, Brazil. Methods We prospectively assessed all medical and nonmedical costs of inpatients admitted with a diagnosis of any stroke or transient ischemic attack over one year, analyzed costs per type of stroke and treatment, length of stay (LOS) and compared hospital costs with government reimbursement. Results We evaluated 274 patients. The total cost for the year was US$1,307,114; the government reimbursed the hospital US$1,095,118. We found a significant linear correlation between LOS and costs (r = 0.71). The median cost of 134 IS inpatients who did not undergo cerebral reperfusion (National Institutes of Health Stroke Scale [NIHSS] median = 3 ) was US$2,803; for IS patients who underwent intravenous (IV) alteplase (NIHSS 10), the median was US$5,099, and for IS patients who underwent IV plus an intra-arterial (IA) thrombectomy (NIHSS > 10), the median cost was US$10,997. The median costs of a primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack were US$2,436, US$8,031 and US$2,677, respectively. Conclusions Reperfusion treatments were two-to-four times more expensive than conservative treatment. A cost-effectiveness study of the IS treatment option is necessary.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000600404&lng=en&tlng=enStrokehospital custscost of illnesssocioeconomic factors |
| spellingShingle | Juliana SAFANELLI Luana Gabriela Dalla Rosa VIEIRA Tainá de ARAUJO Lidiana Fachinete Silva MANCHOPE Maria Helena Ribeiro KUHLHOFF Vivian NAGEL Adriana Bastos CONFORTO Gisele Sampaio SILVA Suleimy MAZIN Pedro Silva Corrêa de MAGALHÃES Norberto Luiz CABRAL The cost of stroke in a public hospital in Brazil: a one-year prospective study Arquivos de Neuro-Psiquiatria Stroke hospital custs cost of illness socioeconomic factors |
| title | The cost of stroke in a public hospital in Brazil: a one-year prospective study |
| title_full | The cost of stroke in a public hospital in Brazil: a one-year prospective study |
| title_fullStr | The cost of stroke in a public hospital in Brazil: a one-year prospective study |
| title_full_unstemmed | The cost of stroke in a public hospital in Brazil: a one-year prospective study |
| title_short | The cost of stroke in a public hospital in Brazil: a one-year prospective study |
| title_sort | cost of stroke in a public hospital in brazil a one year prospective study |
| topic | Stroke hospital custs cost of illness socioeconomic factors |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000600404&lng=en&tlng=en |
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