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Cost of Acute and Sub-Acute Care for Stroke Patients

Orathai Khiaocharoen BN, Med, PhD*, Supasit Pannarunothai MD, PhD**, Chairoj Zungsontiporn MD***

Affiliation : * Research Development Division, Phitsanulok Provincial Health Office, Phitsanulok, Thailand ** Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand *** Central Office for Healthcare Information, Bangkok, Thailand

Background : Stroke is an important health problem that imposes socioeconomic burdens.
Objective : To explore provider costs and to examine predictive factors for cost of acute and sub-acute inpatient services for stroke patients. Material and Method: The present study design was prevalence-based cost-of-illness with micro-costing approach. Subjects were 407 first episode stroke patients. Patient costs were prospectively recorded from July 2008 to March 2009.
Results : The average cost per admission was 32,372 Baht. The cost of acute phase was higher than that of sub-acute phase. Moreover, costs were significantly different among disability levels. Predictors of cost in acute phase included surgery, hemorrhagic pathology, and length of stay (adjusted R2 = 0.755; p < 0.001). Additional predictors of costs in sub-acute phase included initial Barthel index, gender, rehabilitation treatment, and the hospital (adjusted R2 = 0.748; p < 0.001).
Conclusion : Cost of stroke was influenced by patient characteristics, pathology, treatments, and phases of care that should be considered in reimbursement system policy.

Keywords : Cost of stroke, Acute, Sub-acute care, Micro-costing approach


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MEDICAL ASSOCIATION OF THAILAND
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