The cost of pediatric stroke care and rehabilitation.
OBJECTIVE
There is little data regarding the cost of pediatric stroke care or the elements that contribute to these costs. We examined costs for poststroke care during the first year after diagnosis and compared these costs with the volume of the cerebral infarct and the level of neurological and functional outcome.


METHODS
We identified 39 children who sustained nontraumatic ischemic or hemorrhagic strokes and confirmed the diagnoses by review of medical and radiology records. Medical costs were tabulated for the year after the diagnosis of stroke. Cerebral infarct volumes were measured from MRI or CT scans. Neurological outcome was assessed by telephone with a modification of the Pediatric Stroke Outcome Measure (PSOM), and functional outcomes were assessed with a standardized quality-of-life measure.


RESULTS
The median cost for poststroke care during the year after diagnosis was $42,338 for the entire group. The cost for stroke care was higher for hemorrhagic stroke than for ischemic stroke. Cost had a significant positive correlation with neurological impairment. The modified PSOM score positively correlated with impairments of physical, emotional, social, and school function.


CONCLUSIONS
The cost of stroke care may be one measure of stroke severity, with more extensive strokes resulting in greater medical costs. In addition, stroke appears to impair children's social ability along with their neurological function.
Lo
Warren
W
Department of Pediatrics, The Ohio State University, Children's Hospital, 700 Children's Dr, Columbus, OH 43205, USA. wlo@chi.osu.edu
Zamel
Khaled
K
Ponnappa
Kavita
K
Allen
Antoni
A
Chisolm
Deena
D
Tang
Monica
M
Kerlin
Bryce
B
Yeates
Keith O
KO
D000293:Adolescent; D002544:Cerebral Infarction / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D012046:Rehabilitation / Q000191:economics; D012720:Severity of Illness Index; D020521:Stroke / Q000191:economics* / Q000503:physiopathology; D000071939:Stroke Rehabilitation