title: Costs of hospitalization for stroke patients aged 18-64 years in the United States.
abstract: BACKGROUND
  Estimates for the average cost of stroke have varied 20-fold in the United States. To provide a robust cost estimate, we conducted a comprehensive analysis of the hospitalization costs for stroke patients by diagnosis status and event type.
  
  
  METHODS
  Using the 2006-2008 MarketScan inpatient database, we identified 97,374 hospitalizations with a primary or secondary diagnosis of stroke. We analyzed the costs after stratifying the hospitalizations by stroke type (hemorrhagic, ischemic, and other strokes) and diagnosis status (primary and secondary). We employed regressions to estimate the impact of event type and diagnosis status on costs while controlling for major potential confounders.
  
  
  RESULTS
  Among the 97,374 hospitalizations (average cost: $20,396 ± $23,256), the number with ischemic, hemorrhagic, or other strokes was 62,637, 16,331, and 48,208, respectively, with these types having average costs, in turn, of $18,963 ± $21,454, $32,035 ± $32,046, and $19,248 ± $21,703. A majority (62%) of the hospitalizations had stroke listed as a secondary diagnosis only. Regression analysis found that, overall, hemorrhagic stroke cost $14,499 more than ischemic stroke (P < .001). For hospitalizations with a primary diagnosis of ischemic stroke, those with a secondary diagnosis of ischemic heart disease (IHD) had costs that were $9836 higher (P < .001) than those without IHD.
  
  
  CONCLUSIONS
  The costs of hospitalizations involving stroke are high and vary greatly by type of stroke, diagnosis status, and comorbidities. These findings should be incorporated into cost-effective strategies to reduce the impact of stroke.
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: Gbw9@cdc.gov.
authors: Guijing
authors: G
authors: Wang
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Zefeng
authors: Z
authors: Zhang
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Carma
authors: C
authors: Ayala
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Diane O
authors: DO
authors: Dunet
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Jing
authors: J
authors: Fang
authors: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Mary G
authors: MG
authors: George
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D018803:Models, Economic; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cost; comorbidity; diagnosis type; stroke type
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