Die Kosten des Schlaganfalls — eine Längsschnittanalyse

Abstract

Background

Stroke is one of the main causes of morbidity and mortality in both men and women in the European Union. It is the third leading cause of death and the most common cause of disability in adults worldwide. The Federal Statistical Office of Germany reported total costs of € 8.1 billion for 2008 due to approximately 200,000 strokes per year. Demographic change will lead to a further increase in stroke incidence. There are few economic studies on the costs associated with stroke.

Methods

We performed a retrospective review of the medical, hospital and drug claims data in the database of a German statutory health insurance covering about 5 million insurees. The data for patients suffering from stroke were extracted by using the documented hospital ICD-10 codes during 2004 and 2005. For these patients we reviewed and summarized all the charges incurred over a one-year period after the initial index event on the basis of weekly costs and from the third party payer’s perspective.

Results

18,106 patients who experienced stroke during 2004 or 2005 were identified and selected. 30% of these patients died during the period of data availability. Mean total costs per patient during the first year after stroke were approximately € 11,822. The attributable costs of stroke were € 3,573. The main proportion of total annual costs occurred during the period of acute care. Four weeks after the initial stroke event the costs reached 50% of total annual costs and were mainly driven by inpatient costs. The mean duration of hospital stay of acute inpatients was 1.86 weeks.

Conclusion

From a third party payer’s perspective, stroke is associated with a considerable economic burden. These costs, in particular are incurred during periods of inpatient stays. For this reason, effective stroke prevention and efficient inpatient process and therapy management need to be first priority.