Aim: To estimate the cost of treating stroke in the UK.
Methods: A cost-of-illness model was constructed to estimate stroke-related costs over a 5-year period. The cost estimates were based on data from a large, randomised, prospective study comparing alternative strategies of stroke care. The study collected detailed data on resource use in hospital, primary care, healthcare contacts, and utilisation of social services over a period of 1 year following stroke. A Markov framework was used to extrapolate 1-year costs over 5 years.
Results: The model estimated that, for every patient who experiences a stroke, the cost to the NHS in the UK is £15 306 over 5 years and, when informal care costs are included, the amount increases to £29 405 (2001/2002 prices). The robustness of the cost findings was explored with the use of sensitivity analysis. This focused on the key variables of rates of recurrent stroke, the estimated acute costs, and costs attached to institution and home care.
Conclusion: As well as being a considerable cause of morbidity and mortality, stroke is also a huge cost burden to both the UK’s NHS and the carers of stroke victims.
Acute Stroke Informal Care Severe Stroke Personal Social Service Mild Stroke
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
This study was supported by a grant from Pfizer Ltd to Fourth Hurdle, a contract research organisation.
Wolfe CD, Rudd A, Beech R. Stroke services and research: an overview with recommendations for future research. London: Stroke Association, 1996Google Scholar
Rudd AG, Irwin P, Rutledge Z, et al. The national sentinel audit of stroke: a tool for raising standards of care. J R Coll Physicians Lond 1999; 33 (5): 460–4PubMedGoogle Scholar
Hansson L, Lloyd A, Anderson P, et al. Excess morbidity and cost of failure to achieve targets for blood pressure control in Europe. Blood Press 2002; 11: 35–45PubMedCrossRefGoogle Scholar
Lloyd A, Schmieder C, Marchant N. Financial and health costs of uncontrolled blood pressure in the United Kingdom. Pharmacoeconomics 2003; 21 Suppl. 1: 33–41PubMedCrossRefGoogle Scholar
Dewey HM, Thrift AG, Mihalopoulos C, et al. Informal care for stroke survivors: results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2002; 33: 1028–33PubMedCrossRefGoogle Scholar
Hickenbottom SL, Fendrick AM, Kutcher JS, et al. A national study of the quantity and cost of informal caregiving for the elderly with stroke. Neurology 2002; 58: 1754–9PubMedCrossRefGoogle Scholar
Kavanagh S, Knapp M, Patel A. Costs and disability among stroke patients. J Public Health Med 1999; 21 (4): 385–94PubMedCrossRefGoogle Scholar
Kalra L, Evans A, Perez I, et al. Alternative strategies for stroke care: a prospective randomised controlled trial. Lancet 2000; 356: 894–9PubMedCrossRefGoogle Scholar
Collin C, Wade DT, Davies S, et al. The Barthel ADL Index: a reliability study. Int Disabil Stud 1988; 10 (2): 61–3PubMedCrossRefGoogle Scholar
Pyke R. Markov renewal processes: definitions and preliminary properties. Ann Math Stat 1961; 32: 1231–42CrossRefGoogle Scholar
Wade DT, Hewer RL. Functional abilities after stroke: measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry 1987; 50: 177–82PubMedCrossRefGoogle Scholar
Bamford J, Dennis M, Sandercock P, et al. The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg Psychiatry 1990; 53: 824–9PubMedCrossRefGoogle Scholar
Burn J, Dennis M, Bamford J, et al. Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke 1994; 25: 333–7PubMedCrossRefGoogle Scholar
Scott A, Evandrou M, Falkingham J, et al. Moves into residential care amongst older people in Britain. Paper presented to the 2001 British Household Panel Survey Research Conference; 2001 July 5–7; Colchester, UKGoogle Scholar
Bebbington A, Brown P, Darton R, et al. Survey of admissions to residential and nursing home care: 30 month follow-up. London: Personal Social Services Research Unit (PSSRU), Apr 1999. PSSRU Discussion Paper 1537Google Scholar
Netten A, Rees T, Harrison G. Unit costs of health and social care 2001. Canterbury: Personal Social Services Research Unit (PSSRU), 2001Google Scholar
Bamford J, Sandercock P, Dennis M, et al. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–86: 2. Incidence, case fatality rates and overall outcomes at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990; 53 (1): 16–22PubMedCrossRefGoogle Scholar
Beech R, Rudd AG, Tilling K, et al. Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an inner-London teaching hospital. Stroke 1999; 30: 729–35PubMedCrossRefGoogle Scholar
McNamee P, Christensen J, Soutter J, et al. Cost analysis of early supported hospital discharge for stroke. Age Aging 1998; 27: 345–51CrossRefGoogle Scholar
Payne KA, Huybrechts KF, Caro JJ, et al. Long term cost-of-illness in stroke: an international review. Pharmacoeconomics 2002; 20 (12): 813–25PubMedCrossRefGoogle Scholar
Gage BF, Cardinalli AB, Albers GW, et al. Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. JAMA 1995; 274 (23): 1839–45PubMedCrossRefGoogle Scholar
Caro JJ, Huybrechts KF. Stroke treatment economic model (STEM): predicting long-term costs from functional status. Stroke 1999; 30: 2574–9PubMedCrossRefGoogle Scholar
Moeremans K, Aliot E, de Chillou C, et al. Second line pharmacological management of paroxysmal and persistent atrial fibrillation in France: a cost analysis. Value Health 2000; 3 (6): 407–16PubMedCrossRefGoogle Scholar
O’Brien JA, Caro I, Getsios D, et al. Diabetes in Canada: direct medical costs of major macrovascular complications. Value Health 2001; 4 (3): 258–65PubMedCrossRefGoogle Scholar
Department of Health. National Service Framework for Older people. London: Department of Health, Mar 2001Google Scholar