Estimating the economic burden of stroke in China: a cost-of-illness study

Abstract

Objectives: Stroke imposes a heavy economic burden and loss of productivity on individuals and society. This study assessed a range of crucial factors, including direct costs and indirect costs, to gauge the economic implications of stroke in China. These outcomes were evaluated with specific reference to the year 2018, using the Chinese yuan (¥) as the unit of measurement and providing the corresponding purchasing power parity dollar ($PPP) currency value.

Methods: A cost-of-illness methodology was used to ascertain the economic implications of stroke in 2018. Within the constraints of this approach, economic costs were defined as 'direct costs' or 'indirect costs'. We estimated direct costs from sample data, the National Health Service Survey and the National Health Account and Health Statistical Yearbook. A human capital method was used to conservatively estimate indirect costs.

Results: In 2018, of the economic burden of stroke in China, the direct costs were ¥247.8 billion ($PPP 58.6 billion) and indirect costs were ¥704.4 billion ($PPP 166.5 billion). The curative care expenditure for stroke was ¥193.1 billion ($PPP 45.7 billion), consuming nearly 5.5% of curative expenditure. The cost of stroke treatment relied heavily on public financing, with 58% from social health insurance and 14% from government sources.

Conclusions: A significant economic burden is imposed by stroke on China's economy, and there is a risk of underestimating this burden if indirect costs are not comprehensively considered. The importance of implementing effective preventive measures and screening strategies for stroke, with a particular focus on high-risk populations, is underscored by this study's findings. Such investments in public health have the potential to yield substantial benefits.

Keywords: China; chronic disease; health economics; public health; stroke.

Figure 1

Components of stroke curative costs, by types in China, 2018 (%).

Figure 2

Age distribution of stroke curative costs vs total curative costs in China, 2018 (%).

Figure 3

Gender composition of stroke curative costs in China, 2018 (%).

Figure 4

Composition of stroke expenditure by financing schemes, 2018 (%).

Figure 5

Composition of indirect costs of stroke, by age group, in China, 2018 (%). YLD, years lost due to disability or morbidity; YLL, years of life lost.