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. 2021 Sep-Oct;14(5):606-619.
doi: 10.25122/jml-2021-0361.

The economic burden of stroke: a systematic review of cost of illness studies

Stefan Strilciuc  1   2   3 , Diana Alecsandra Grad  2   3 , Constantin Radu  2 , Diana Chira  2 , Adina Stan  1   2 , Marius Ungureanu  3   4 , Adrian Gheorghe  5 , Fior-Dafin Muresanu  1   2
Affiliations

The economic burden of stroke: a systematic review of cost of illness studies

Stefan Strilciuc et al. J Med Life. 2021 Sep-Oct.

Abstract

Stroke is one of the leading causes of morbidity and mortality worldwide. As the number of stroke cases is rising from one year to another, policymakers require data on the amount spent on stroke to enforce better financing policies for prevention, hospital care, outpatient rehabilitation services and social services. We aimed to systematically assess the economic burden of stroke at global level. Cost of stroke studies were retrieved from five databases. We retrieved the average cost per patient, where specified, or estimated it using a top-down approach. Resulting costs were grouped in two main categories: per patient per year and per patient lifetime. We extracted information from forty-six cost of illness studies. Per patient per year costs are larger in high income countries and in studies conducted from the payer perspective. The highest average per patient per year cost by country was reported in the United States ($59,900), followed by Sweden ($52,725) and Spain ($41,950). The highest per patient lifetime costs were reported in Australia ($232,100) for all identified definitions of stroke. Existing literature regarding the economic burden of stroke is concentrated in high-income settings, with very few studies conducted in South America and Africa. Published manuscripts on this topic highlight substantial methodological heterogeneity, rendering comparisons difficult or impossible, even within the same country or among studies with similar costing perspectives.

Keywords: cost of illness; economic burden; hemorrhagic; ischemic; stroke; transient ischemic attack.

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Figures

Figure 1.
Figure 1.
PRISMA Flow Diagram.
Figure 2.
Figure 2.
Per patient per year costs (USD 2020) represented as box plots (light orange – provider perspective; orange – payer perspective; dark orange – societal perspective).
Figure 3.
Figure 3.
Average per patient per year costs (USD 2020) by country classification and study perspective (n – number of studies).
Figure 4.
Figure 4.
Average per patient per year costs (USD 2020) by country classification and study perspective (light orange – provider perspective; orange – payer perspective; dark orange – societal perspective) (n – number of studies).
Figure 5.
Figure 5.
Per patient per year costs (USD 2020) by country classification (n – number of studies).
Figure 6.
Figure 6.
Cost estimates aggregated by country. Colors represent World Bank income classification (light orange – high income; orange – upper-middle-income; dark orange – low-middle income; brown – low income; SP – study perspectives used in the analyses; n – number of studies).
Figure 7.
Figure 7.
World map reflecting per patient per year costs (USD 2020). Map figures show country averages across studies analyzed (color gradient: light – lower values, dark – higher values; n – number of studies).
Figure 8.
Figure 8.
Per patient lifetime costs (USD 2020) represented as box plots (light orange – provider perspective; dark orange – societal perspective).
See this image and copyright information in PMC

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