title: Impact of disability status on ischemic stroke costs in Canada in the first year.
abstract: BACKGROUND
  Longitudinal, patient-level data on resource use and costs after an ischemic stroke are lacking in Canada. The objectives of this analysis were to calculate costs for the first year post-stroke and determine the impact of disability on costs.
  
  
  METHODS
  The Economic Burden of Ischemic Stroke (BURST) Study was a one-year prospective study with a cohort of ischemic stroke patients recruited at 12 Canadian stroke centres. Clinical history, disability, health preference and resource utilization information was collected at discharge, three months, six months and one year. Resources included direct medical costs (2009 CAN$) such as emergency services, hospitalizations, rehabilitation, physician services, diagnostics, medications, allied health professional services, homecare, medical/assistive devices, changes to residence and paid caregivers, as well as indirect costs. Results were stratified by disability measured at discharge using the modified Rankin Score (mRS): non-disabling stroke (mRS 0-2) and disabling stroke (mRS 3-5).
  
  
  RESULTS
  We enrolled 232 ischemic stroke patients (age 69.4 ± 15.4 years; 51.3% male) and 113 (48.7%) were disabled at hospital discharge. The average annual cost was $74,353; $107,883 for disabling strokes and $48,339 for non-disabling strokes.
  
  
  CONCLUSIONS
  An average annual cost for ischemic stroke was calculated in which a disabling stroke was associated with a two-fold increase in costs compared to NDS. Costs during the hospitalization to three months phase were the highest contributor to the annual cost. A "back of the envelope" calculation using 38,000 stroke admissions and the average annual cost yields $2.8 billion as the burden of ischemic stroke.
authors.affiliation: Research Centre, Sunnybrook Health Sciences Centre Sunnybrook Health Sciences Centre, 2075 Bayview Aveune, E240, Toronto, Ontario, M4N 3M5, Canada. nicole.mittmann@sri.utoronto.ca
authors.forename: Nicole
authors.initials: N
authors.lastname: Mittmann
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Seung
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Phillips
authors.forename: Vladimir
authors.initials: V
authors.lastname: Hachinski
authors.forename: Robert
authors.initials: R
authors.lastname: Coté
authors.forename: Brian H
authors.initials: BH
authors.lastname: Buck
authors.forename: Ariane
authors.initials: A
authors.lastname: Mackey
authors.forename: David J
authors.initials: DJ
authors.lastname: Gladstone
authors.forename: David C
authors.initials: DC
authors.lastname: Howse
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Shuaib
authors.forename: Mike
authors.initials: M
authors.lastname: Sharma
mesh_terms: D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D013997:Time Factors