title: High total hospitalization cost but low cost of imaging studies in recurrent acute ischemic stroke patients.
abstract: BACKGROUND
  Due to the high risk and severity of recurrence after stroke attack, recurrence is a major reason contributing to the disease burden. This study aims to determine whether recurrence is a significant contributor of hospitalization cost in items for ischemic stroke patients.
  
  
  METHODS
  This study assessed acute ischemic stroke patients admitted to an academic medical center in 2003 through 2009. The t-test and Chi-square tests were used to compare first-ever and recurrent ischemic stroke groups in terms of total and categorized hospitalization cost, and multiple regression was performed to assess the influence of stroke recurrence.
  
  
  RESULTS
  Recurrent ischemic strokes were associated with higher total cost, but examination cost showed no difference between the two groups. The recurrent stroke group showed higher laboratory but lower imaging cost. Of imaging studies, there was no significant difference in computed tomography scan cost while the first-ever stroke group spent more on magnetic resonance imaging and sonography. Controlling for other influential factors, recurrence was discovered to be a significant factor in lowering examination cost.
  
  
  CONCLUSIONS
  The findings of stroke recurrence in lowering examination cost could be explained from two perspectives, different clinical patterns of healthcare utilization and patients' economic status in recurrent stroke.
authors.affiliation: Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, Catholic University of Korea, Seoul, Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kwon
authors.affiliation: Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Sung Sang
authors.initials: SS
authors.lastname: Yoon
authors.affiliation: Department of Health Services Management, Kyung Hee University School of Management, Seoul, Korea.
authors.forename: Hyejung
authors.initials: H
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D000368:Aged; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis* / Q000191:economics*; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D002546:Ischemic Attack, Transient; D008279:Magnetic Resonance Imaging / Q000191:economics; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000191:economics*; D014057:Tomography, X-Ray Computed / Q000191:economics