title: Economic impact of patients admitted to stroke units in Spain.
abstract: OBJECTIVE
  Stroke is a major social and health problem. However, since the recent incorporation of new advances in its management, little is known about the cost of stroke. The aim of this study is to find out the real cost of stroke in Spain.
  
  
  METHODS
  This is an epidemiological, observational, prospective, multicenter study of patients diagnosed with stroke and admitted to a stroke unit. Patients were recruited from 16 hospitals throughout Spain and followed up for 1 year. Sociodemographic, clinical, and economic data were collected. Costs (€ 2012) were estimated from the social perspective and were divided into direct healthcare (inpatient, outpatient, and medication), direct non-healthcare (mainly formal and informal care) and labor productivity losses.
  
  
  RESULTS
  A total of 321 patients were included. Mean age was 72.1 years and 176 patients (54.8 %) were male. Total average cost per patient/year was €27,711. Direct healthcare costs amounted to €8491 per patient/year (68.8 % due to inpatient costs) and non-healthcare costs to an average of €18,643 per patient/year (89.5 % due to informal care). Productivity loss costs per patient/year were €276. Total costs of hemorrhagic strokes were slightly higher than ischemic (€28,895 vs. €27,569 per patient/year, p = 0.550) without significant differences. The main variables associated with higher costs were the presence of hypertension (€30,332 vs. €23,234 per patient/year, p < 0.05) and the severity of stroke (p < 0.05), both independently associated after a multivariate analysis.
  
  
  CONCLUSIONS
  The cost of patients admitted to stroke units in Spain is €27,711 per patient/year. More than two-thirds are social costs, mainly informal care. Stroke remains a major burden on health systems and society, so additional efforts are needed for its prevention.
authors.affiliation: Servei de Neurologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. josalvarez@vhebron.net.
authors.forename: Jose
authors.initials: J
authors.lastname: Alvarez-Sabín
authors.affiliation: Servei de Neurologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Quintana
authors.affiliation: Stroke Unit, Department of Neurology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Masjuan
authors.affiliation: Department of Economic Analysis, Universidad de Castilla La Mancha and REDISSEC, Toledo, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Oliva-Moreno
authors.affiliation: Clinical Management Service, Hospital Alto Deba, Mondragon, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Mar
authors.affiliation: Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Gonzalez-Rojas
authors.affiliation: Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Becerra
authors.affiliation: Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain.
authors.forename: Covadonga
authors.initials: C
authors.lastname: Torres
authors.affiliation: Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Yebenes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006761:Hospitals; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000191:economics*; D011446:Prospective Studies; D012947:Social Work / Q000191:economics; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000191:economics* / Q000401:mortality; D011795:Surveys and Questionnaires
keywords: Cost of illness; Economic impact; Healthcare and non-healthcare costs; Social perspective; Stroke