The iScore predicts total healthcare costs early after hospitalization for an acute ischemic stroke.
BACKGROUND
The ischemic Stroke risk score is a validated prognostic score which can be used by clinicians to estimate patient outcomes after the occurrence of an acute ischemic stroke.


OBJECTIVE
In this study, we examined the association between the ischemic Stroke risk score and patients' 30-day, one-year, and two-year healthcare costs from the perspective of a third party healthcare payer.


METHODS
Patients who had an acute ischemic stroke were identified from the Registry of Canadian Stroke Network. The 30-day ischemic Stroke risk score prognostic score was determined for each patient. Direct healthcare costs at each time point were determined using administrative databases in the province of Ontario. Unadjusted mean and the impact of a 10-point increase ischemic Stroke risk score and a patient's risk of death or disability on total cost were determined.


RESULTS
There were 12,686 patients eligible for the study. Total unadjusted mean costs were greatest among patients at high risk. When adjusting for patient characteristics, a 10-point increase in the ischemic Stroke risk score was associated with 8%, 7%, and 4% increase in total costs at 30 days, one-year, and two-years. The same increase was found to impact patients at low, medium, and high risk differently. When adjusting for patient characteristics, patients in the high-risk group had the highest total costs at 30 days, while patients at medium risk had the highest costs at both one and two-years.


CONCLUSIONS
The ischemic Stroke risk score can be useful as a predictor of healthcare utilization and costs early after hospitalization for an acute ischemic stroke.
The Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Emmanuel M
EM
Ewara
The Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Wanrudee
W
Isaranuwatchai
VHA Health Services Research and Development (HSR&D), Stroke Quality Enhancement Research Initiative (QUERI), Washington, DC, USA.|VHA, HSR&D Center of Innovation on Health Information and Communication, Indianapolis, IN, USA.|Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.|Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Regenstrief Institute, Indianapolis, IN, USA.
Dawn M
DM
Bravata
VHA Health Services Research and Development (HSR&D), Stroke Quality Enhancement Research Initiative (QUERI), Washington, DC, USA.|VHA, HSR&D Center of Innovation on Health Information and Communication, Indianapolis, IN, USA.|Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Regenstrief Institute, Indianapolis, IN, USA.
Linda S
LS
Williams
Institute of Clinical Evaluative Sciences, Toronto, ON, Canada.
Jiming
J
Fang
The Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.|Institute of Clinical Evaluative Sciences, Toronto, ON, Canada.
Jeffrey S
JS
Hoch
Department of Neurology, University of Toronto School of Medicine, Toronto, ON, Canada.|Division of Neurology, St. Michael's Hospital, Toronto, ON, Canada.
Gustavo
G
Saposnik
D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis* / Q000191:economics* / Q000628:therapy; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011379:Prognosis; D012042:Registries; D012044:Regression Analysis; D012306:Risk; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000191:economics* / Q000628:therapy; D013997:Time Factors
cost; outcomes; risk scores; stroke; stroke management