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Published in: PharmacoEconomics 1/2003

01-12-2003 | Original Research Article

The Economic Burden of Stroke in the United Kingdom

Authors: Penny Youman, Koo Wilson, Farzaneh Harraf, Lalit Kalra

Published in: PharmacoEconomics | Special Issue 1/2003

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Abstract

Aim: To estimate the cost of treating stroke in the UK.
Methods: A cost-of-illness model was constructed to estimate stroke-related costs over a 5-year period. The cost estimates were based on data from a large, randomised, prospective study comparing alternative strategies of stroke care. The study collected detailed data on resource use in hospital, primary care, healthcare contacts, and utilisation of social services over a period of 1 year following stroke. A Markov framework was used to extrapolate 1-year costs over 5 years.
Results: The model estimated that, for every patient who experiences a stroke, the cost to the NHS in the UK is £15 306 over 5 years and, when informal care costs are included, the amount increases to £29 405 (2001/2002 prices). The robustness of the cost findings was explored with the use of sensitivity analysis. This focused on the key variables of rates of recurrent stroke, the estimated acute costs, and costs attached to institution and home care.
Conclusion: As well as being a considerable cause of morbidity and mortality, stroke is also a huge cost burden to both the UK’s NHS and the carers of stroke victims.
Literature
1.
go back to reference Wolfe CD, Rudd A, Beech R. Stroke services and research: an overview with recommendations for future research. London: Stroke Association, 1996 Wolfe CD, Rudd A, Beech R. Stroke services and research: an overview with recommendations for future research. London: Stroke Association, 1996
2.
go back to reference Rudd AG, Irwin P, Rutledge Z, et al. The national sentinel audit of stroke: a tool for raising standards of care. J R Coll Physicians Lond 1999; 33 (5): 460–4PubMed Rudd AG, Irwin P, Rutledge Z, et al. The national sentinel audit of stroke: a tool for raising standards of care. J R Coll Physicians Lond 1999; 33 (5): 460–4PubMed
3.
go back to reference Hansson L, Lloyd A, Anderson P, et al. Excess morbidity and cost of failure to achieve targets for blood pressure control in Europe. Blood Press 2002; 11: 35–45PubMedCrossRef Hansson L, Lloyd A, Anderson P, et al. Excess morbidity and cost of failure to achieve targets for blood pressure control in Europe. Blood Press 2002; 11: 35–45PubMedCrossRef
4.
go back to reference Lloyd A, Schmieder C, Marchant N. Financial and health costs of uncontrolled blood pressure in the United Kingdom. Pharmacoeconomics 2003; 21 Suppl. 1: 33–41PubMedCrossRef Lloyd A, Schmieder C, Marchant N. Financial and health costs of uncontrolled blood pressure in the United Kingdom. Pharmacoeconomics 2003; 21 Suppl. 1: 33–41PubMedCrossRef
5.
go back to reference Dewey HM, Thrift AG, Mihalopoulos C, et al. Informal care for stroke survivors: results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2002; 33: 1028–33PubMedCrossRef Dewey HM, Thrift AG, Mihalopoulos C, et al. Informal care for stroke survivors: results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2002; 33: 1028–33PubMedCrossRef
6.
go back to reference Hickenbottom SL, Fendrick AM, Kutcher JS, et al. A national study of the quantity and cost of informal caregiving for the elderly with stroke. Neurology 2002; 58: 1754–9PubMedCrossRef Hickenbottom SL, Fendrick AM, Kutcher JS, et al. A national study of the quantity and cost of informal caregiving for the elderly with stroke. Neurology 2002; 58: 1754–9PubMedCrossRef
7.
go back to reference Kavanagh S, Knapp M, Patel A. Costs and disability among stroke patients. J Public Health Med 1999; 21 (4): 385–94PubMedCrossRef Kavanagh S, Knapp M, Patel A. Costs and disability among stroke patients. J Public Health Med 1999; 21 (4): 385–94PubMedCrossRef
8.
go back to reference Kalra L, Evans A, Perez I, et al. Alternative strategies for stroke care: a prospective randomised controlled trial. Lancet 2000; 356: 894–9PubMedCrossRef Kalra L, Evans A, Perez I, et al. Alternative strategies for stroke care: a prospective randomised controlled trial. Lancet 2000; 356: 894–9PubMedCrossRef
9.
go back to reference Collin C, Wade DT, Davies S, et al. The Barthel ADL Index: a reliability study. Int Disabil Stud 1988; 10 (2): 61–3PubMedCrossRef Collin C, Wade DT, Davies S, et al. The Barthel ADL Index: a reliability study. Int Disabil Stud 1988; 10 (2): 61–3PubMedCrossRef
10.
go back to reference Pyke R. Markov renewal processes: definitions and preliminary properties. Ann Math Stat 1961; 32: 1231–42CrossRef Pyke R. Markov renewal processes: definitions and preliminary properties. Ann Math Stat 1961; 32: 1231–42CrossRef
11.
go back to reference Wade DT, Hewer RL. Functional abilities after stroke: measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry 1987; 50: 177–82PubMedCrossRef Wade DT, Hewer RL. Functional abilities after stroke: measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry 1987; 50: 177–82PubMedCrossRef
12.
go back to reference Bamford J, Dennis M, Sandercock P, et al. The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg Psychiatry 1990; 53: 824–9PubMedCrossRef Bamford J, Dennis M, Sandercock P, et al. The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg Psychiatry 1990; 53: 824–9PubMedCrossRef
13.
go back to reference Burn J, Dennis M, Bamford J, et al. Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke 1994; 25: 333–7PubMedCrossRef Burn J, Dennis M, Bamford J, et al. Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke 1994; 25: 333–7PubMedCrossRef
14.
go back to reference Scott A, Evandrou M, Falkingham J, et al. Moves into residential care amongst older people in Britain. Paper presented to the 2001 British Household Panel Survey Research Conference; 2001 July 5–7; Colchester, UK Scott A, Evandrou M, Falkingham J, et al. Moves into residential care amongst older people in Britain. Paper presented to the 2001 British Household Panel Survey Research Conference; 2001 July 5–7; Colchester, UK
16.
go back to reference Bebbington A, Brown P, Darton R, et al. Survey of admissions to residential and nursing home care: 30 month follow-up. London: Personal Social Services Research Unit (PSSRU), Apr 1999. PSSRU Discussion Paper 1537 Bebbington A, Brown P, Darton R, et al. Survey of admissions to residential and nursing home care: 30 month follow-up. London: Personal Social Services Research Unit (PSSRU), Apr 1999. PSSRU Discussion Paper 1537
17.
go back to reference Netten A, Rees T, Harrison G. Unit costs of health and social care 2001. Canterbury: Personal Social Services Research Unit (PSSRU), 2001 Netten A, Rees T, Harrison G. Unit costs of health and social care 2001. Canterbury: Personal Social Services Research Unit (PSSRU), 2001
18.
go back to reference Bamford J, Sandercock P, Dennis M, et al. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–86: 2. Incidence, case fatality rates and overall outcomes at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990; 53 (1): 16–22PubMedCrossRef Bamford J, Sandercock P, Dennis M, et al. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–86: 2. Incidence, case fatality rates and overall outcomes at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990; 53 (1): 16–22PubMedCrossRef
19.
go back to reference Beech R, Rudd AG, Tilling K, et al. Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an inner-London teaching hospital. Stroke 1999; 30: 729–35PubMedCrossRef Beech R, Rudd AG, Tilling K, et al. Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an inner-London teaching hospital. Stroke 1999; 30: 729–35PubMedCrossRef
20.
go back to reference McNamee P, Christensen J, Soutter J, et al. Cost analysis of early supported hospital discharge for stroke. Age Aging 1998; 27: 345–51CrossRef McNamee P, Christensen J, Soutter J, et al. Cost analysis of early supported hospital discharge for stroke. Age Aging 1998; 27: 345–51CrossRef
21.
go back to reference Payne KA, Huybrechts KF, Caro JJ, et al. Long term cost-of-illness in stroke: an international review. Pharmacoeconomics 2002; 20 (12): 813–25PubMedCrossRef Payne KA, Huybrechts KF, Caro JJ, et al. Long term cost-of-illness in stroke: an international review. Pharmacoeconomics 2002; 20 (12): 813–25PubMedCrossRef
22.
go back to reference Gage BF, Cardinalli AB, Albers GW, et al. Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. JAMA 1995; 274 (23): 1839–45PubMedCrossRef Gage BF, Cardinalli AB, Albers GW, et al. Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. JAMA 1995; 274 (23): 1839–45PubMedCrossRef
23.
go back to reference Caro JJ, Huybrechts KF. Stroke treatment economic model (STEM): predicting long-term costs from functional status. Stroke 1999; 30: 2574–9PubMedCrossRef Caro JJ, Huybrechts KF. Stroke treatment economic model (STEM): predicting long-term costs from functional status. Stroke 1999; 30: 2574–9PubMedCrossRef
24.
go back to reference Taylor TN, Davis PH, Torner JC, et al. Lifetime cost of stroke in the United States. Stroke 1996; 27: 1459–66PubMedCrossRef Taylor TN, Davis PH, Torner JC, et al. Lifetime cost of stroke in the United States. Stroke 1996; 27: 1459–66PubMedCrossRef
25.
go back to reference Moeremans K, Aliot E, de Chillou C, et al. Second line pharmacological management of paroxysmal and persistent atrial fibrillation in France: a cost analysis. Value Health 2000; 3 (6): 407–16PubMedCrossRef Moeremans K, Aliot E, de Chillou C, et al. Second line pharmacological management of paroxysmal and persistent atrial fibrillation in France: a cost analysis. Value Health 2000; 3 (6): 407–16PubMedCrossRef
26.
go back to reference O’Brien JA, Caro I, Getsios D, et al. Diabetes in Canada: direct medical costs of major macrovascular complications. Value Health 2001; 4 (3): 258–65PubMedCrossRef O’Brien JA, Caro I, Getsios D, et al. Diabetes in Canada: direct medical costs of major macrovascular complications. Value Health 2001; 4 (3): 258–65PubMedCrossRef
27.
go back to reference Department of Health. National Service Framework for Older people. London: Department of Health, Mar 2001 Department of Health. National Service Framework for Older people. London: Department of Health, Mar 2001
Metadata
Title
The Economic Burden of Stroke in the United Kingdom
Authors
Penny Youman
Koo Wilson
Farzaneh Harraf
Lalit Kalra
Publication date
01-12-2003
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue Special Issue 1/2003
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200321001-00005

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