Future costs of stroke in the Netherlands: the impact of stroke services.
OBJECTIVE
In the next decades, the number of stroke patients is expected to increase. Furthermore, organizational changes, such as stroke services, are expected to be implemented on a large scale. The purpose of this study is to estimate the future healthcare costs by taking into account the expected increase of stroke patients and a nationwide implementation of stroke services.


METHODS
By means of a dynamic multistate life table, the total number of stroke patients can be projected. The model calculates the annual number of patients by age and gender. The total healthcare costs are calculated by multiplying the average healthcare costs specified by age, gender, and healthcare sector with the total number of stroke patients specified by age and gender.


RESULTS
In the year 2000, the healthcare costs for stroke amounted to euro 1.62 billion. This amount is approximately 4.4 percent of the total national healthcare budget. Projections of the total costs of stroke based on current practice result in an increase of 28 percent (euro 2.08 billion) in the year 2020. A nationwide implementation of stroke services in 2020 would result in a substantial reduction of the costs of stroke (euro 1.81 billion: 13 percent cost reduction) compared with the regular care scenario.


CONCLUSIONS
A nationwide implementation of stroke services is a strong policy tool for cost containment of health care in an aging population like that in the Netherlands. Policy makers should optimize the organization of stroke care.
Struijs
Jeroen N
JN
Centre for Prevention and Health Services Research, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. jeroen.struijs@rivm.nl
van Genugten
Marianne L L
ML
Evers
Silvia M A A
SM
Ament
André J H
AJ
Baan
Caroline A
CA
van den Bos
Geertrudis A M
GA
D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000191:economics* / Q000639:trends; D005260:Female; D005544:Forecasting / Q000379:methods; D017048:Health Care Costs / Q000639:trends*; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011050:Policy Making; D011157:Population Dynamics; D012046:Rehabilitation / Q000191:economics; D020521:Stroke / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D000071939:Stroke Rehabilitation