Cost of stroke in Australia from a societal perspective: results from the North East Melbourne Stroke Incidence Study (NEMESIS).
OBJECTIVE
Accurate information about resource use and costs of stroke is necessary for informed health service planning. The purpose of this study was to determine the patterns of resource use among stroke patients and to estimate the total costs (direct service use and indirect production losses) of stroke (excluding SAH) in Australia for 1997.


METHODS
An incidence-based cost-of-illness model was developed, incorporating data obtained from the North East Melbourne Stroke Incidence Study (NEMESIS). The costs of stroke during the first year after stroke and the present value of total lifetime costs of stroke were estimated.


RESULTS
The total first-year costs of all first-ever-in-a lifetime strokes (SAH excluded) that occurred in Australia during 1997 were estimated to be A$555 million (US$420 million), and the present value of lifetime costs was estimated to be A$1.3 billion (US$985 million). The average cost per case during the first 12 months and over a lifetime was A$18 956 (US$14 361) and A$44 428 (US$33 658), respectively. The most important categories of cost during the first year were acute hospitalization (A$154 million), inpatient rehabilitation (A$150 million), and nursing home care (A$63 million). The present value of lifetime indirect costs was estimated to be A$34 million.


CONCLUSIONS
Similar to other studies, hospital and nursing home costs contributed most to the total cost of stroke (excluding SAH) in Australia. Inpatient rehabilitation accounts for approximately 27% of total first-year costs. Given the magnitude of these costs, investigation of the cost-effectiveness of rehabilitation services should become a priority in this community.
Dewey
H M
HM
National Stroke Research Institute and the Neurology Department, Austin and Repatriation Medical Centre, Heidelberg, Australia. helend@austin.unimelb.edu.au
Thrift
A G
AG
Mihalopoulos
C
C
Carter
R
R
Macdonell
R A
RA
McNeil
J J
JJ
Donnan
G A
GA
D000368:Aged; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006699:Home Care Services / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009735:Nursing Homes / Q000191:economics; D012042:Registries / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000191:economics* / Q000453:epidemiology; D000071939:Stroke Rehabilitation; D013995:Time