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Observational Study
. 2024 Aug 27;9(4):380-389.
doi: 10.1136/svn-2023-002296.

One-year direct and indirect costs of ischaemic stroke in China

Wei Lv #  1   2 , Anxin Wang #  1   2 , Qianyi Wang #  3 , Ruimin Wang  1   2 , Qin Xu  1   2 , Shuqing Wu  4 , Yi Han  5 , Yong Jiang  1   2 , Jinxi Lin  1   2 , Jing Jing  1   2 , Hao Li  1   2 , Yongjun Wang  1   2 , Xia Meng  6   2
Affiliations
Observational Study

One-year direct and indirect costs of ischaemic stroke in China

Wei Lv et al. Stroke Vasc Neurol. .

Abstract

Background: This is the first real-world study to estimate the direct costs and indirect costs of first-ever ischaemic stroke with 1-year follow-up in China, based on a nationally representative sample.

Methods: Patients were chosen from 20 geographically diverse sites from the nationally representative database China National Stroke Registry-III (CNSR-III). The inclusion criteria were surviving patients who were hospitalised with first-ever ischaemic stroke from February 2017 to February 2018 (the index event); aged 18-80 during the index event; no history of other stroke types. The primary endpoints were direct medical costs, direct non-medical costs, indirect costs and total cost (ie, the sum of all cost components). Patient characteristics and clinical data were extracted from CNSR-III. Stroke-related in-hospital direct medical costs were collected from hospital electronic medical records. The patient survey collected data related to out-of-hospital direct medical costs, direct non-medical costs and indirect costs. The secondary objective was to explore clinical factors associated with cost outcomes through univariate analysis and multiple regression.

Results: The study enrolled 520 patients. The total cost was 57 567.48 CNY, with 26 612.67 CNY direct medical costs, 2 787.56 CNY direct non-medical costs and 28 167.25 CNY indirect costs. Univariate analysis showed that longer lengths of stay during the index event, higher National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale scores were associated with higher costs in all categories. Conversely, EuroQol 5 Dimension utility scores were associated with decreased costs except direct non-medical costs. Multiple regressions showed that higher admission NIHSS scores were independently associated with higher direct medical costs, indirect costs and total cost. Higher 3-month utilities were associated with lower total cost.

Conclusion: This real-world study showed substantial 1-year economic burden following first-ever ischaemic stroke in China, and that indirect costs are a non-negligible driver of costs.

Keywords: Cerebrovascular Disorders; Stroke.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study population flowchart. CNSR, China National Stroke Registry; EMR, electronic medical record; TIA, transient ischaemic attack.
See this image and copyright information in PMC

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References

    1. Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circ Res 2017;120:439–48. 10.1161/CIRCRESAHA.116.308413 - DOI - PubMed
    1. Liu M, Wu B, Wang W-Z, et al. . Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol 2007;6:456–64. 10.1016/S1474-4422(07)70004-2 - DOI - PubMed
    1. Wang Y-J, Li Z-X, Gu H-Q, et al. . China stroke Statistics 2019: a report from the National center for Healthcare quality management in neurological diseases, China National clinical research center for neurological diseases, the Chinese stroke association, national center for chronic and non-communicable disease control and prevention, Chinese center for disease control and prevention and Institute for global neuroscience and stroke collaborations. Stroke Vasc Neurol 2020;5:211–39. 10.1136/svn-2020-000457 - DOI - PMC - PubMed
    1. Li X, Zhang X. Annual data set on national mortality surveillance. Beijing: China Science and Technology Press; 2018.
    1. Wang Y, Cui L, Ji X, et al. . The China national stroke registry for patients with acute cerebrovascular events: design, rationale, and baseline patient characteristics. Int J Stroke 2011;6:355–61. 10.1111/j.1747-4949.2011.00584.x - DOI - PubMed

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