Acute Treatment Costs of Stroke in Brazil

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dc.contributor.authorChristensen, Michael C.
dc.contributor.authorValiente, Raul
dc.contributor.authorSilva, Gisele Sampaio [UNIFESP]
dc.contributor.authorLee, Won Chan
dc.contributor.authorDutcher, Sarah
dc.contributor.authorGuimaraes Rocha, Maria Sheila
dc.contributor.authorMassaro, Ayrton [UNIFESP]
dc.contributor.institutionNovo Nordisk AS
dc.contributor.institutionHosp Santa Marcelina
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionAbt Biopharma Solut Inc
dc.date.accessioned2016-01-24T13:52:09Z
dc.date.available2016-01-24T13:52:09Z
dc.date.issued2009-01-01
dc.description.abstractBackground and Purpose: Although stroke is the leading cause of death in Brazil, little information exist on the acute treatment provided for stroke and its associated costs. This study addresses this gap by both clinically and economically characterizing the acute treatment of first-ever intracerebral hemorrhage (ICH) and ischemic stroke ( IS) in Brazil. Methods: Retrospective medical chart review using data from two high-volume stroke centers in São Paulo, Brazil. Clinical and resource utilization data for all patients admitted to the stroke centers with a first-ever stroke between January 1, 2006 and May 31, 2007 were collected and the mean acute treatment costs per person were calculated by assigning appropriate unit cost data to all resource use. Cost estimates in Brazilian reals (BRL) were converted to US dollars (USD) using the 2005 purchasing power parity index. National costs of acute treatment for incident strokes were estimated by extrapolation of mean cost estimate per person to national incidence data for the two types of stroke. the mean costs of acute treatment on a national scale were examined in sensitivity analysis. Results: A total of 316 stroke patients were identified and their demographic and clinical characteristics, patterns of care, and outcomes were examined. Mean length of hospital stay was 12.0 8 +/- 8.8 days for ICH and 13.3 +/- 8 23.4 days for IS. Ninety-one percent of the ICH patients and 68% of the IS patients were admitted to an intensive care unit (ICU). Mean total costs of initial hospitalization were USD 4,101 (SD +/- 4,254) for ICH and USD 1,902 (SD +/- 1,426) for IS. in multivariate analysis, hemorrhagic stroke, development of pneumonia, neurosurgical intervention, stay in ICU, and physical therapy were all significant independent predictors of acute treatment costs. Aggregate national health care expenditures for acute treatment of incident ICH were USD 122.4 million (range 30.8-274.2) and USD 326.9 million for IS (range 82.4-732.2). Conclusion: Acute treatment costs of incident ICH and IS in Brazil are substantial and primarily driven by the intensity of hospital treatment and in-hospital complications. With the expected increase in the incidence of stroke in Brazil over the coming decades, these results emphasize the need for effective preventive and acute medical care. Copyright (C) 2008 S. Karger AG, Baselen
dc.description.affiliationNovo Nordisk AS, Global Dev, DK-2880 Bagsvaerd, Denmark
dc.description.affiliationHosp Santa Marcelina, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Paulista Sch Med, São Paulo, Brazil
dc.description.affiliationAbt Biopharma Solut Inc, Bethesda, MD USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Paulista Sch Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNovo Nordisk A/S
dc.format.extent142-149
dc.identifierhttp://dx.doi.org/10.1159/000184747
dc.identifier.citationNeuroepidemiology. Basel: Karger, v. 32, n. 2, p. 142-149, 2009.
dc.identifier.doi10.1159/000184747
dc.identifier.issn0251-5350
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/31218
dc.identifier.wosWOS:000262548900010
dc.language.isoeng
dc.publisherKarger
dc.relation.ispartofNeuroepidemiology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.karger.com/Services/RightsPermissions
dc.subjectIntracerebral hemorrhageen
dc.subjectIschemic strokeen
dc.subjectHospital costs, Brazilen
dc.titleAcute Treatment Costs of Stroke in Brazilen
dc.typeinfo:eu-repo/semantics/article
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