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Published in: BMC Neurology 1/2011

Open Access 01-12-2011 | Research article

The impact of acquired brain damage in terms of epidemiology, economics and loss in quality of life

Authors: Javier Mar, Arantzazu Arrospide, José María Begiristain, Isabel Larrañaga, Elena Elosegui, Juan Oliva-Moreno

Published in: BMC Neurology | Issue 1/2011

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Abstract

Background

Patients with acquired brain damage (ABD) have suffered a brain lesion that interrupts vital development in the physical, psychological and social spheres. Stroke and traumatic brain injury (TBI) are the two main causes. The objectives of this study were to estimate the incidence and prevalence of ABD in the population of the Basque Country and Navarre in 2008, to calculate the associated cost of the care required and finally to assess the loss in health-related quality of life.

Methods

On the one hand, a cross-sectional survey was carried out, in order to estimate the incidence of ABD and its consequences in terms of costs and loss in quality of life from the evolution of a sample of patients diagnosed with stroke and TBI. On the other hand, a discrete event simulation model was built that enabled the prevalence of ABD to be estimated. Finally, a calculation was made of the formal and informal costs of ABD in the population of the Basque Country and Navarre (2,750,000 people).

Results

The cross-sectional study showed that the incidences of ABD caused by stroke and TBI were 61.8 and 12.5 cases per 100,000 per year respectively, while the overall prevalence was 657 cases per 100,000 people. The SF-36 physical and mental component scores were 28.9 and 44.5 respectively. The total economic burden was calculated to be 382.14 million euro per year, distributed between 215.27 and 166.87 of formal and informal burden respectively. The average cost per individual was 21,040 € per year.

Conclusions

The main conclusion of this study is that ABD has a high impact in both epidemiological and economic terms as well as loss in quality of life. The overall prevalence obtained is equivalent to 0.7% of the total population. The substantial economic burden is distributed nearly evenly between formal and informal costs. Specifically, it was found that the physical dimensions of quality of life are the most severely affected. The prevalence-based approach showed adequate to estimate the population impact of ABD and the resources needed to compensate the disability.
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Literature
1.
go back to reference Rothwell PM: The high cost of not funding stroke research: a comparison with heart disease and cancer. Lancet. 2001, 357: 1612-1616. 10.1016/S0140-6736(00)04730-9.CrossRefPubMed Rothwell PM: The high cost of not funding stroke research: a comparison with heart disease and cancer. Lancet. 2001, 357: 1612-1616. 10.1016/S0140-6736(00)04730-9.CrossRefPubMed
2.
go back to reference Ommaya AK, Ommaya AK, Dannenberg AL, Salazar AM: Causation, incidence, and costs of traumatic brain injury in the U.S. military medical system. J Trauma. 1996, 40: 211-217. 10.1097/00005373-199602000-00007.CrossRefPubMed Ommaya AK, Ommaya AK, Dannenberg AL, Salazar AM: Causation, incidence, and costs of traumatic brain injury in the U.S. military medical system. J Trauma. 1996, 40: 211-217. 10.1097/00005373-199602000-00007.CrossRefPubMed
3.
go back to reference McGarry LJ, Thompson D, Millham FH, Cowell L, Snyder PJ, Lenderking WR, Weinstein MC: Outcomes and costs of acute treatment of traumatic brain injury. J Trauma. 2002, 53: 1152-1159. 10.1097/00005373-200212000-00020.CrossRefPubMed McGarry LJ, Thompson D, Millham FH, Cowell L, Snyder PJ, Lenderking WR, Weinstein MC: Outcomes and costs of acute treatment of traumatic brain injury. J Trauma. 2002, 53: 1152-1159. 10.1097/00005373-200212000-00020.CrossRefPubMed
4.
go back to reference Kayani NA, Homan S, Yun S, Zhu BP: Health and economic burden of traumatic brain injury: Missouri, 2001-2005. Public Health Rep. 2009, 124: 551-560.PubMedPubMedCentral Kayani NA, Homan S, Yun S, Zhu BP: Health and economic burden of traumatic brain injury: Missouri, 2001-2005. Public Health Rep. 2009, 124: 551-560.PubMedPubMedCentral
5.
go back to reference Evers SM, Struijs JN, Ament AJ, van Genugten ML, Jager JH, van den Bos GA: International comparison of stroke cost studies. Stroke. 2004, 35: 1209-1215. 10.1161/01.STR.0000125860.48180.48.CrossRefPubMed Evers SM, Struijs JN, Ament AJ, van Genugten ML, Jager JH, van den Bos GA: International comparison of stroke cost studies. Stroke. 2004, 35: 1209-1215. 10.1161/01.STR.0000125860.48180.48.CrossRefPubMed
6.
go back to reference Youman P, Wilson K, Harraf F, Kalra L: The economic burden of stroke in the United Kingdom. Pharmacoeconomics. 2003, 21 (suppl 1): 43-50. 10.2165/00019053-200321001-00005.CrossRefPubMed Youman P, Wilson K, Harraf F, Kalra L: The economic burden of stroke in the United Kingdom. Pharmacoeconomics. 2003, 21 (suppl 1): 43-50. 10.2165/00019053-200321001-00005.CrossRefPubMed
7.
go back to reference Arrazola A, Begiristain JM, Mar J: Hospital care of cerebrovascular accident and the state of patients 12 months after. 2005. Rev Neurol. 2005, 40: 326-30.PubMed Arrazola A, Begiristain JM, Mar J: Hospital care of cerebrovascular accident and the state of patients 12 months after. 2005. Rev Neurol. 2005, 40: 326-30.PubMed
8.
go back to reference Hankey GJ: Stroke treatment and prevention: an evidence-based approach. 2005, New York: Cambridge University Press, 1-8.CrossRef Hankey GJ: Stroke treatment and prevention: an evidence-based approach. 2005, New York: Cambridge University Press, 1-8.CrossRef
9.
go back to reference Langton Hewer R, Tennant A: The epidemiology of disabling neurological disorders. Handbook of neurological rehabilitation. Edited by: Greenwood RJ, Barnes MP, McMillan TM, Ward CD. 2003, Hove: Psychology Press, 5-14. Langton Hewer R, Tennant A: The epidemiology of disabling neurological disorders. Handbook of neurological rehabilitation. Edited by: Greenwood RJ, Barnes MP, McMillan TM, Ward CD. 2003, Hove: Psychology Press, 5-14.
10.
go back to reference Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997, 349: 1436-42. 10.1016/S0140-6736(96)07495-8.CrossRefPubMed Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997, 349: 1436-42. 10.1016/S0140-6736(96)07495-8.CrossRefPubMed
11.
go back to reference Knapp M, Prince M: Dementia UK: the full report. 2007, London, Alzheimer's Society Knapp M, Prince M: Dementia UK: the full report. 2007, London, Alzheimer's Society
12.
go back to reference Comas M, Castells X, Hoffmeister L, Roman R, Cots F, Mar J, Gutierrez-Moreno S, Espallargues M: Discrete-event simulation applied to the analysis of waiting lists. Evaluation of a prioritization system for cataract surgery. Value Health. 2008, 11: 1203-1213. 10.1111/j.1524-4733.2008.00322.x.CrossRefPubMed Comas M, Castells X, Hoffmeister L, Roman R, Cots F, Mar J, Gutierrez-Moreno S, Espallargues M: Discrete-event simulation applied to the analysis of waiting lists. Evaluation of a prioritization system for cataract surgery. Value Health. 2008, 11: 1203-1213. 10.1111/j.1524-4733.2008.00322.x.CrossRefPubMed
13.
go back to reference Mahoney FI, Barthel DW: Functional evaluation: the Barthel index. Md Med J. 1965, 14: 61-65. Mahoney FI, Barthel DW: Functional evaluation: the Barthel index. Md Med J. 1965, 14: 61-65.
14.
go back to reference Lawton MP, Brody EM: Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist. 1969, 9: 179-186.CrossRefPubMed Lawton MP, Brody EM: Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist. 1969, 9: 179-186.CrossRefPubMed
15.
go back to reference Ware JR, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed Ware JR, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
16.
go back to reference EuroQoL Group: EuroQoL - A new facility for measurement of health -related quality of life. Health Policy. 1990, 16: 199-208. 10.1016/0168-8510(90)90421-9.CrossRef EuroQoL Group: EuroQoL - A new facility for measurement of health -related quality of life. Health Policy. 1990, 16: 199-208. 10.1016/0168-8510(90)90421-9.CrossRef
17.
go back to reference Drummond MF, O'Brien B, Stoddard G, Torrance GW: Methods for the economic evaluation of health care programmes. 1997, Oxford: Oxford University Press, 52-95. 2 Drummond MF, O'Brien B, Stoddard G, Torrance GW: Methods for the economic evaluation of health care programmes. 1997, Oxford: Oxford University Press, 52-95. 2
18.
go back to reference Hervas A, Forcén T: Coste del cuidado informal del ictus en una población general no institucionalizada. Gac Sanitaria. 2007, 21: 444-451. 10.1157/13112236.CrossRef Hervas A, Forcén T: Coste del cuidado informal del ictus en una población general no institucionalizada. Gac Sanitaria. 2007, 21: 444-451. 10.1157/13112236.CrossRef
20.
go back to reference Badía X, Roset M, Montserrat S, Herdman M, Segura A: La versión española del EuroQol: descripción y aplicaciones. Med Clin (Barc). 1999, 112 (suppl 1): S79-S86. Badía X, Roset M, Montserrat S, Herdman M, Segura A: La versión española del EuroQol: descripción y aplicaciones. Med Clin (Barc). 1999, 112 (suppl 1): S79-S86.
21.
go back to reference Alonso J, Prieto L, Antó JM: La versión española del SF-36 Health Survey (Cuestionario de salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc). 1995, 104: 771-776. Alonso J, Prieto L, Antó JM: La versión española del SF-36 Health Survey (Cuestionario de salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc). 1995, 104: 771-776.
23.
go back to reference Cohen J: Statistical power analysis for the behavioural sciences. 1977, New York: Academic Press, 8- Cohen J: Statistical power analysis for the behavioural sciences. 1977, New York: Academic Press, 8-
24.
go back to reference Mar J, Sainz-Ezkerra M, Moler-Cuiral JA: Calculation of prevalence estimates through differential equations: Application to stroke-related disability. Neuroepidemiology. 2008, 31: 57-66. 10.1159/000140096.CrossRefPubMed Mar J, Sainz-Ezkerra M, Moler-Cuiral JA: Calculation of prevalence estimates through differential equations: Application to stroke-related disability. Neuroepidemiology. 2008, 31: 57-66. 10.1159/000140096.CrossRefPubMed
25.
go back to reference Mar J, Arrospide A, Comas M: Budget Impact Analysis of Thrombolysis for Stroke in Spain: A Discrete Event Simulation Model. Value Health. 2010, 13: 69-76. 10.1111/j.1524-4733.2009.00655.x.CrossRefPubMed Mar J, Arrospide A, Comas M: Budget Impact Analysis of Thrombolysis for Stroke in Spain: A Discrete Event Simulation Model. Value Health. 2010, 13: 69-76. 10.1111/j.1524-4733.2009.00655.x.CrossRefPubMed
26.
go back to reference Kelton WD, Sadowski RP, Sturrock DT: Simulation with ARENA. 2007, New York, McGraw Hill Kelton WD, Sadowski RP, Sturrock DT: Simulation with ARENA. 2007, New York, McGraw Hill
27.
go back to reference Rothman KJ, Greenland S: Measures of disease frequency. Modern Epidemiology. Edited by: Rothman KJ, Greenland S. 1998, Philadelphia: Lippincott, Williams and Wilkins, 29-46. Rothman KJ, Greenland S: Measures of disease frequency. Modern Epidemiology. Edited by: Rothman KJ, Greenland S. 1998, Philadelphia: Lippincott, Williams and Wilkins, 29-46.
28.
go back to reference Hilden J: Budget impact analysis and its rational basis. Med Decis Making. 2008, 28: 461-2. 10.1177/0272989X08321903.CrossRef Hilden J: Budget impact analysis and its rational basis. Med Decis Making. 2008, 28: 461-2. 10.1177/0272989X08321903.CrossRef
29.
go back to reference López-Bastida J, Perestelo-Pérez L, Montón-Álvarez F, Serrano-Aguilar P: Social economic costs and health-related quality of life in patients with degenerative cerebellar ataxia in Spain. Movement Disorders. 2008, 23: 212-217.CrossRefPubMed López-Bastida J, Perestelo-Pérez L, Montón-Álvarez F, Serrano-Aguilar P: Social economic costs and health-related quality of life in patients with degenerative cerebellar ataxia in Spain. Movement Disorders. 2008, 23: 212-217.CrossRefPubMed
30.
go back to reference López-Bastida J, Oliva-Moreno J, Perestelo-Pérez L, Serrano-Aguilar P: The economic costs and health-related quality of life of people with HIV/AIDS in the Canary Islands, Spain. BMC Health Serv Res. 2009, 9: 55-CrossRefPubMedPubMedCentral López-Bastida J, Oliva-Moreno J, Perestelo-Pérez L, Serrano-Aguilar P: The economic costs and health-related quality of life of people with HIV/AIDS in the Canary Islands, Spain. BMC Health Serv Res. 2009, 9: 55-CrossRefPubMedPubMedCentral
31.
go back to reference López-Bastida J, Serrano-Aguilar P, Perestelo-Pérez L, Oliva-Moreno J: Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain. Neurology. 2006, 67: 2186-2191.CrossRefPubMed López-Bastida J, Serrano-Aguilar P, Perestelo-Pérez L, Oliva-Moreno J: Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain. Neurology. 2006, 67: 2186-2191.CrossRefPubMed
32.
go back to reference van den Berg B, Brouwer W, van Exel J, Koopmanschap M, van den Bos GA, Rutten F: Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods. Soc Sci Med. 2006, 62: 835-845. 10.1016/j.socscimed.2005.06.046.CrossRefPubMed van den Berg B, Brouwer W, van Exel J, Koopmanschap M, van den Bos GA, Rutten F: Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods. Soc Sci Med. 2006, 62: 835-845. 10.1016/j.socscimed.2005.06.046.CrossRefPubMed
33.
go back to reference van den Berg B, Brouwer W, Koopmanschap M: Economic valuation of informal care: An overview of methods and applications. Eur J Health Econ. 2004, 5: 36-45. 10.1007/s10198-003-0189-y.CrossRefPubMed van den Berg B, Brouwer W, Koopmanschap M: Economic valuation of informal care: An overview of methods and applications. Eur J Health Econ. 2004, 5: 36-45. 10.1007/s10198-003-0189-y.CrossRefPubMed
34.
go back to reference Comas-Herrera A, Wittenberg R, Costa-Font J, Gori C, Di Maio A, Patxot C, et al: Future Long-Term Care Expenditure in Germany, Spain, Italy and the United Kingdom. Ageing Soc. 2006, 26: 285-302. 10.1017/S0144686X05004289.CrossRef Comas-Herrera A, Wittenberg R, Costa-Font J, Gori C, Di Maio A, Patxot C, et al: Future Long-Term Care Expenditure in Germany, Spain, Italy and the United Kingdom. Ageing Soc. 2006, 26: 285-302. 10.1017/S0144686X05004289.CrossRef
35.
go back to reference Hu TW: Perspectives: an international review of the national cost estimates of mental illness, 1990-2003. J Ment Health Policy Econ. 2006, 9: 3-13.PubMed Hu TW: Perspectives: an international review of the national cost estimates of mental illness, 1990-2003. J Ment Health Policy Econ. 2006, 9: 3-13.PubMed
36.
go back to reference Consejo Interterritorial del Sistema Nacional de Salud: Estrategia en ictus del Sistema Nacional de Salud. 2009, Madrid: Ministerio de Sanidad y Consumo Consejo Interterritorial del Sistema Nacional de Salud: Estrategia en ictus del Sistema Nacional de Salud. 2009, Madrid: Ministerio de Sanidad y Consumo
37.
go back to reference Oliva J, López-Bastida J, Montejo AL, Osuna R, Duque B: The socioeconomic costs of mental illness in Spain. Eur J Health Econ. 2009, 10: 361-369. 10.1007/s10198-008-0135-0.CrossRef Oliva J, López-Bastida J, Montejo AL, Osuna R, Duque B: The socioeconomic costs of mental illness in Spain. Eur J Health Econ. 2009, 10: 361-369. 10.1007/s10198-008-0135-0.CrossRef
Metadata
Title
The impact of acquired brain damage in terms of epidemiology, economics and loss in quality of life
Authors
Javier Mar
Arantzazu Arrospide
José María Begiristain
Isabel Larrañaga
Elena Elosegui
Juan Oliva-Moreno
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2011
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-11-46

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