title: Stroke in Switzerland: social determinants of treatment access and cost of illness.
abstract: BACKGROUND
  Few useful empirical data on stroke are available for Switzerland. The aim of this study was to collect data on the use of medical resources and associated costs among stroke patients. Special attention was paid to possible correlations between epidemiologic indicators, sociodemographic variables, resource use, and costs.
  
  
  METHODS
  We carried out a representative population survey of 19,123 households in the German- and French-speaking parts of Switzerland with computer-assisted telephone interviews in 2005. Detailed sociodemographic data and information on the use of resources were collected from 509 individuals aged 15-75 years who had cared for a stroke patient in the past 1-2 years.
  
  
  RESULTS
  In the last 1-2 years, a total of 7.8% of households were affected by stroke in the German-speaking part of Switzerland, whereas only 4.3% of households were affected in the French-speaking part of Switzerland (odds ratio [OR] = 1.89, P < .001). Based on the length of stay, the total cost of inpatient treatment and rehabilitation during the average 1-year observation period was estimated at €40,090. Stroke therefore caused approximately 2.9% of all inpatient costs in Switzerland. Patients with supplementary insurance were treated more frequently as inpatients than patients with statutory insurance (OR: 2.14, P = .014), and patients with a low household income were referred less frequently to an inpatient rehabilitation facility than those with medium or high household income (OR = .58, P < .05).
  
  
  CONCLUSIONS
  This survey confirms the medical and economic importance of stroke and supplements the existing European data. Further research is needed in regard to incidence differences in stroke across Switzerland. Patients without supplementary insurance or with low household income were less likely to receive inpatient treatment.
authors.affiliation: University of Zurich, Institute of Social and Preventive Medicine, Medical Economics, Zurich, Switzerland. Electronic address: snozzi@gmail.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Snozzi
authors.affiliation: University of Zurich, Institute of Social and Preventive Medicine, Medical Economics, Zurich, Switzerland.
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Blank
authors.affiliation: Institute of Pharmaceutical Medicine, University of Basel, Basel, Switzerland.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Szucs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics*; D054625:Healthcare Disparities / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D007182:Income; D007348:Insurance, Health / Q000191:economics; D016018:Least-Squares Analysis; D007902:Length of Stay / Q000191:economics; D016015:Logistic Models; D008134:Long-Term Care / Q000191:economics; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Stroke; Switzerland; cost factors; cost-of-illness; economics; epidemiology; socioeconomic factors; stroke facilities; stroke prevalence; stroke rehabilitation