title: Direct costs of modern treatment of aneurysmal subarachnoid hemorrhage in the first year after diagnosis.
abstract: OBJECTIVE
  The purpose of this study was to investigate the current direct costs of modern management of patients with aneurysmal subarachnoid hemorrhage in the first year after diagnosis.
  
  
  METHODS
  During a 1-year period, we studied all admitted patients with subarachnoid hemorrhage from a population of 2 million people. We calculated the direct costs of treatment, which included the costs of medical and nursing care and the related travel expenses of patients. We calculated true costs for all major healthcare resources. National census data, if available, and standard charges were used to determine healthcare resource expenses.
  
  
  RESULTS
  Hospital admissions and diagnostic and therapeutic interventions in 110 patients accounted for 85% of all costs; 64% of the total direct medical costs during admission were the medical, nursing, and overhead costs alone. Patients discharged directly to home generated 4% of the total budget, whereas admission to a nursing home accounted for the remaining 11% of the total costs. Of the diagnostic and therapeutic costs, 45% was caused by imaging and 42% by surgery or coiling. Angiography alone accounted for 52% of the total imaging costs and 24% of the total diagnostic and therapeutic costs. Prescribed medication accounted for only 3% of the total budget of diagnostic and therapeutic costs.
  
  
  CONCLUSIONS
  Most direct costs during the first year after aneurysmal subarachnoid hemorrhage are caused by the hospital inpatient days, accounting for two thirds of the total costs generated during the first year after the initial bleeding. If new costly treatments succeed in reducing the average length of inpatient hospital stays, then progress in therapy may prove cost effective and might even be cost saving.
authors.affiliation: Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands. Y.B.Roos@amc.uva.nl
authors.forename: Y B W E M
authors.initials: YB
authors.lastname: Roos
authors.forename: M G W
authors.initials: MG
authors.lastname: Dijkgraaf
authors.forename: K W
authors.initials: KW
authors.lastname: Albrecht
authors.forename: L F M
authors.initials: LF
authors.lastname: Beenen
authors.forename: R J M
authors.initials: RJ
authors.lastname: Groen
authors.forename: R J
authors.initials: RJ
authors.lastname: de Haan
authors.forename: M
authors.initials: M
authors.lastname: Vermeulen
mesh_terms: D015331:Cohort Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D023261:Glasgow Outcome Scale; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009426:Netherlands; D009732:Nursing Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000191:economics* / Q000628:therapy*; D013995:Time