title: More hemorrhagic and severe events cause higher hospitalization care cost for childhood stroke in Taiwan.
abstract: OBJECTIVE
  Rarely has childhood stroke been compared with adult stroke for incidence or cost. This population study compared the stroke incidence and the associated hospitalization care costs between children and adults in Taiwan.
  
  
  METHODS
  We used reimbursement claims data from the National Health Insurance program to identify stroke diagnoses in 1997 to 2003. The inpatient costs of both the first admission and recurrent stroke from 1979 childhood cases and 365,169 adult cases were compared by age and stroke subtype, excluding those less than 1 month of age.
  
  
  RESULTS
  The mean inpatient costs were higher for patients <10 and 10 to 19 years of age ($3565 per case) compared with adult cases ($1933), including both first and recurrent hospitalizations, and they were higher for the recurrent cases. Patients <10 years old had the highest proportional incidence of hemorrhage events (71.4%), followed by patients in the 10- to 19-year-old group (61.4%), and the lowest for adults (21.3%). Hemorrhagic events incurred 2 to 12 times higher cost than other types of stroke.
  
  
  CONCLUSIONS
  The hospitalization care costs for stroke are higher for children than for adults because of a greater proportion of hemorrhagic cases among children.
authors.affiliation: Institution of Environmental Health, National Taiwan University Hospital, Taipei.
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chen
authors.forename: Kuo-Liong
authors.initials: KL
authors.lastname: Chien
authors.forename: Ching-Wen
authors.initials: CW
authors.lastname: Chang
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.forename: Yuan-Teh
authors.initials: YT
authors.lastname: Lee
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy; D002648:Child; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis* / Q000191:economics* / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis; D013624:Taiwan