title: The future cost of stroke in Ireland: an analysis of the potential impact of demographic change and implementation of evidence-based therapies.
abstract: OBJECTIVE
  this paper examines the impact of demographic change from 2007 to 2021 on the total cost of stroke in Ireland and analyses potential impacts of expanded access to stroke unit care and thrombolytic therapy on stroke outcomes and costs.
  
  
  METHODS
  total costs of stroke are estimated for the projected number of stroke cases in 2021 in Ireland. Analysis also estimates the potential number of deaths or institutionalised cases averted among incident stroke cases in Ireland in 2007 at different rates of access to stroke unit care and thrombolytic therapy. Drawing on these results, total stroke costs in Ireland in 2007 are recalculated on the basis of the revised numbers of incident stroke patients estimated to survive stroke, and of the numbers estimated to reside at home rather than in a nursing home in the context of expanded access to stroke units or thrombolytic therapy.
  
  
  RESULTS
  future costs of stroke in Ireland are estimated to increase by 52-57% between 2007 and 2021 on the basis of demographic change. The projected increase in aggregate stroke costs for all incident cases in 1 year in Ireland due to the delivery of stroke unit care and thrombolytic therapy can be offset to some extent by reductions in nursing home and other post-acute costs.
authors.affiliation: Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland. samantha.smith@esri.ie
authors.forename: Samantha
authors.initials: S
authors.lastname: Smith
authors.forename: Frances
authors.initials: F
authors.lastname: Horgan
authors.forename: Eithne
authors.initials: E
authors.lastname: Sexton
authors.forename: Seamus
authors.initials: S
authors.lastname: Cowman
authors.forename: Anne
authors.initials: A
authors.lastname: Hickey
authors.forename: Peter
authors.initials: P
authors.lastname: Kelly
authors.forename: Hannah
authors.initials: H
authors.lastname: McGee
authors.forename: Sean
authors.initials: S
authors.lastname: Murphy
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
authors.forename: Maeve
authors.initials: M
authors.lastname: Royston
authors.forename: Emer
authors.initials: E
authors.lastname: Shelley
authors.forename: Miriam
authors.initials: M
authors.lastname: Wiley
mesh_terms: D000359:Aftercare / Q000191:economics; D017046:Cost Savings; D019317:Evidence-Based Medicine / Q000191:economics*; D005544:Forecasting; D017048:Health Care Costs / Q000639:trends; D006297:Health Services Accessibility / Q000191:economics* / Q000639:trends; D006699:Home Care Services / Q000191:economics; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D018803:Models, Economic; D009735:Nursing Homes / Q000191:economics; D010351:Patient Discharge / Q000191:economics; D020521:Stroke / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D017741:Survivors; D015912:Thrombolytic Therapy / Q000191:economics* / Q000639:trends; D013997:Time Factors