title: Resource utilization and costs for treatment of stroke patients in an acute stroke unit in Greece.
abstract: BACKGROUND
  Stroke comprises the leading cause of death in Greece, and more than 40% of the overall lifetime cost for stroke care, represents the acute phase hospitalization. The aim of the present study was to assess the resource utilization and estimate the costs for treatment of stroke patients in an Acute Stroke Unit (ASU).
  
  
  METHODS
  Patients with first-ever stroke treated in the ASU of an academic hospital in Athens during 2003-2009 were included in the analysis. The National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) were employed to assess the neurological impairment on admission and the handicap at discharge, respectively. The cost categories measured were: diagnostic investigations, medications, medical and nursing staff, and overhead costs. A generalized linear model was used to predict the mean cost per patient, based on the clinical characteristics of the patients on admission, and during their hospitalization.
  
  
  RESULTS
  In total, 784 patients were included in the analysis, with mean age of 72.2 (11.2) and mean length of hospital stay of 12.3 (9.5) days. The mean cost per patient was estimated at €2,864 (2,198), and the mean cost per day at €244 (54). The relevant cost for the mildly handicapped patients was €1,573 (625), while for the severely handicapped patients it was €4,136 (2,538). Delayed discharge was associated with a mean cost of €362 (634) per patient, while the cost for the acute phase management of the patients was €2,445 (2,471). The neurological impairment on admission (NIHSS score) and the delayed discharge, were strong predictors of the mean cost per patient.
  
  
  CONCLUSIONS
  The costs for treatment of stroke patients in an ASU comprise a significant burden in Greece. Further research should be performed to explore the long-term costs for the treatment of the disease at a nation-wide level.
authors.affiliation: University of Athens, Department of Clinical Therapeutics, Acute Stroke Unit, Greece. Electronic address: persefoni.kritikou@gmail.com.
authors.forename: Persefoni
authors.initials: P
authors.lastname: Kritikou
authors.affiliation: University of Athens, Department of Neurology, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spengos
authors.affiliation: University of Athens, Department of Clinical Therapeutics, Acute Stroke Unit, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Zakopoulos
authors.affiliation: University of Athens, Centre for Health Services Research, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tountas
authors.affiliation: University of Athens, Faculty of Political Science and Public Administration, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Yfantopoulos
authors.affiliation: University of Athens, Department of Clinical Therapeutics, Acute Stroke Unit, Greece; Hellenic Cardiovascular Research Society, Stroke Division, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vemmos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000191:economics / Q000628:therapy*; D005260:Female; D006115:Greece; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000191:economics / Q000628:therapy*
keywords: Cost analysis; Greece; Hospitalization; Resource utilization; Stroke