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Title: Modified Rankin scale as a determinant of direct medical costs after stroke.
Austin Authors: Dewilde, Sarah;Annemans, Lieven;Peeters, Andre;Hemelsoet, Dimitri;Vandermeeren, Yves;Desfontaines, Philippe;Brouns, Raf;Vanhooren, Geert;Cras, Patrick;Michielsens, Boudewijn;Redondo, Patricia;Thijs, Vincent
Affiliation: Department of Public Health, Faculty of Medicine, UGent, Belgium
Services in Health Economics, Brussels, Belgium
Interuniversity Centre for Health Economics Research UGent, VUB, Belgium
Cliniques Universitaires Saint Luc, Service de Neurologie, Brussels, Belgium
Department of Neurology, Ghent University Hospital, Ghent, Belgium
Neurology Department, Université catholique de Louvain (UcL), Yvoir, Belgium
Centre Hospitalier Chrétien (CHC), Site Saint-Joseph, Liège, Belgium
Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium
Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
Department of Neurology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
Department of Neurology, Born Bunge Institute, University and University Hospital, Antwerp, Belgium
Heilig Hart Ziekenhuis, Lier, Belgium
CHU Ambroise Paré, Mons, Belgium
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: Jun-2017 2017-02-06
Publication information: International Journal of Stroke 2017; 12(4): 392-400
Abstract: Background Resource use in the acute and subacute phases after stroke depends on the degree of disability. Aims To determine if direct costs after stroke also vary by level of disability as measured using the modified Rankin scale at the chronic stage after stroke. Methods In a multicentre study, we collected acute and chronic in- and outpatient resource use in survivors of ischemic stroke stratified by levels of disability according to the modified Rankin Scale. Statistical inference on costs at each level of the modified Rankin Scale was estimated using a general linear model for the first three months, the first year, and any subsequent year after ischemic stroke. Results A total of 569 survivors of ischemic stroke with a mean age of 71.7 years were enrolled (41% female) from 10 academic and nonacademic centers. Costs varied substantially over time and with each modified Rankin Scale level. The total average costs in the first year were estimated $33,147 per patient, ranging from $9,114 for modified Rankin Scale 0 to $83,236 for modified Rankin Scale 5. In the second year, medical costs were on average $14,039, varying from $2,921 to $39,723 for patients with modified Rankin Scale 0-5. The level of disability based on the modified Rankin Scale was a major determinant of resource use, irrespective of age, gender, atrial fibrillation, and vascular risk factors. Conclusion Long-term resource use after stroke is high and is mainly driven by degree of disability as measured by the modified Rankin scale.
DOI: 10.1177/1747493017691984
ORCID: 0000-0002-6614-8417
Journal: International Journal of Stroke
PubMed URL: 28164742
Type: Journal Article
Subjects: Stroke
cost analysis
modified Rankin Scale
Appears in Collections:Journal articles

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