The European Journal of Health Economics

, Volume 18, Issue 4, pp 449–458 | Cite as

Economic impact of patients admitted to stroke units in Spain

  • Jose Alvarez-Sabín
  • Manuel Quintana
  • Jaime Masjuan
  • Juan Oliva-Moreno
  • Javier Mar
  • Nuria Gonzalez-Rojas
  • Virginia Becerra
  • Covadonga Torres
  • María Yebenes
  • CONOCES Investigators Group
Original Paper



Stroke is a major social and health problem. However, since the recent incorporation of new advances in its management, little is known about the cost of stroke. The aim of this study is to find out the real cost of stroke in Spain.


This is an epidemiological, observational, prospective, multicenter study of patients diagnosed with stroke and admitted to a stroke unit. Patients were recruited from 16 hospitals throughout Spain and followed up for 1 year. Sociodemographic, clinical, and economic data were collected. Costs (€ 2012) were estimated from the social perspective and were divided into direct healthcare (inpatient, outpatient, and medication), direct non-healthcare (mainly formal and informal care) and labor productivity losses.


A total of 321 patients were included. Mean age was 72.1 years and 176 patients (54.8 %) were male. Total average cost per patient/year was €27,711. Direct healthcare costs amounted to €8491 per patient/year (68.8 % due to inpatient costs) and non-healthcare costs to an average of €18,643 per patient/year (89.5 % due to informal care). Productivity loss costs per patient/year were €276. Total costs of hemorrhagic strokes were slightly higher than ischemic (€28,895 vs. €27,569 per patient/year, p = 0.550) without significant differences. The main variables associated with higher costs were the presence of hypertension (€30,332 vs. €23,234 per patient/year, p < 0.05) and the severity of stroke (p < 0.05), both independently associated after a multivariate analysis.


The cost of patients admitted to stroke units in Spain is €27,711 per patient/year. More than two-thirds are social costs, mainly informal care. Stroke remains a major burden on health systems and society, so additional efforts are needed for its prevention.


Cost of illness Economic impact Healthcare and non-healthcare costs Social perspective Stroke 

JEL Classification

I1 (Health) J14 (Economics of the Elderly) 



CONOCES Investigators Group Juan Francisco Arenillas Lara: Hospital Clínico Universitario de Valladolid, Maite Martínez Zabaleta: Hospital Donostia, Mariano Rebollo Álvarez-Amandi: Hospital Universitario Marqués de Valdecilla, Tomás Segura Martín: Hospital General de Albacete, Aida Lago Martín: Hospital Universitario la Fe, Jaime Gállego Culleré: Hospital de Navarra, Juan Ignacio López Gastón: Hospital Universitario Miguel Servet, Francisco Moniche Álvarez/Mª Dolores Jiménez: Hospital Virgen del Rocío, José Castillo Sánchez: Hospital Clínico de Santiago de Compostela, Mª Carmen Jiménez Martínez: Complejo Asistencial Son Espases, Juan Carlos López Fernández: Complejo Hospitalario Dr. Negrín, Ignacio Casado Naranjo: Complejo Hospitalario de Cáceres, Carmen González Rodríguez: Hospital de Cabueñes, Bernardo Escribano Soriano: Hospital Universitario Virgen de la Arrixaca, Ignacio Hernández Medrano: Hospital Universitario Ramón y Cajal.

Compliance with ethical standards


The study has been funded by an unrestricted grant from Boehringer Ingelheim Spain.

Conflict of interest

Advisor researchers (José Alvarez-Sabin, Jaime Masjuan, Javier Mar and Juan Oliva-Moreno) have received honoraria from Boehringer Ingelheim Spain for their participation in this study. Covadonga Torres and María Yébenes work in PORIB, the firm responsible for the study management. Nuria González-Rojas works for Boehringer Ingelheim Spain. Virginia Becerra worked for Boehringer Ingelheim Spain at the time of the study. Manuel Quintana reports no disclosures.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jose Alvarez-Sabín
    • 1
  • Manuel Quintana
    • 1
  • Jaime Masjuan
    • 2
  • Juan Oliva-Moreno
    • 3
  • Javier Mar
    • 4
  • Nuria Gonzalez-Rojas
    • 5
  • Virginia Becerra
    • 5
  • Covadonga Torres
    • 6
  • María Yebenes
    • 6
  • CONOCES Investigators Group
  1. 1.Servei de NeurologiaHospital Universitari Vall d’Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Stroke Unit, Department of NeurologyHospital Universitario Ramón y Cajal, Universidad de AlcaláMadridSpain
  3. 3.Department of Economic AnalysisUniversidad de Castilla La Mancha and REDISSECToledoSpain
  4. 4.Clinical Management ServiceHospital Alto DebaMondragonSpain
  5. 5.Health Economics and Outcomes ResearchBoehringer Ingelheim EspañaBarcelonaSpain
  6. 6.Pharmacoeconomics and Outcomes Research IberiaMadridSpain

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