title: Cost of post-stroke outpatient care in Malaysia.
abstract: BACKGROUND
  This study aimed to investigate the direct cost of outpatient care for patients with stroke, as well as the relationship between the aforementioned cost and the sociodemographic and stroke characteristics of the patients.
  
  
  METHODS
  This was a cross-sectional study involving patients with first-ever stroke who were attending outpatient stroke rehabilitation, and their family members. Participants were interviewed using a structured questionnaire designed to obtain information regarding the cost of outpatient care. Stroke severity was measured using the National Institute of Health Stroke Scale.
  
  
  RESULTS
  This study comprised 49 patients (28 men, 21 women) with a mean age of 60.2 (range 35-80) years. The mean total cost incurred was USD 547.10 (range USD 53.50-4,591.60), of which 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses. Stroke severity, age > 70 years and haemorrhagic stroke were associated with increased cost. The mean cost of attending outpatient therapy per patient was USD 17.50 per session (range USD 6.60-30.60), with travelling expenses (41.8%) forming the bulk of the cost, followed by medical fees (38.1%) and out-of-pocket expenses (10.9%). Multiple regression analysis showed that stroke severity was the main determinant of post-stroke outpatient care cost (p < 0.001).
  
  
  CONCLUSIONS
  Post-stroke outpatient care costs are significantly influenced by stroke severity. The cost of attendant care was the main cost incurred during the first three months after hospital discharge, while travelling expenses was the main cost incurred when attending outpatient stroke rehabilitation therapy.
authors.forename: Seyed Majid
authors.initials: SM
authors.lastname: Akhavan Hejazi
authors.forename: Mazlina
authors.initials: M
authors.lastname: Mazlan
authors.forename: Saini Jeffery Freddy
authors.initials: SJ
authors.lastname: Abdullah
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. julia@ummc.edu.my.
authors.forename: Julia Patrick
authors.initials: JP
authors.lastname: Engkasan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics*; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000191:economics; D010045:Outpatients; D012046:Rehabilitation / Q000191:economics*; D012720:Severity of Illness Index; D012923:Social Class; D020521:Stroke / Q000191:economics*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires