Costs of Acute Care of First-Ever Ischemic Stroke in Taiwan

Abstract

Background and Purpose— We sought to investigate the direct costs of acute hospitalization for patients with first-ever ischemic stroke in Taiwan. Methods— Data were prospectively collected from 360 first-ever ischemic stroke patients. Hospital charges were used for analysis. Multiple linear regression analysis was used to identify the main factors influencing costs. Results— Mean age was 64.9 years (median, 67.0 years), and 58% were male. Mean National Institutes of Health Stroke Scale (NIHSS) score at admission was 9.4 (median, 6.0). Mean initial score of modified Barthel Index was 10.7 (median, 12.0). Median length of stay was 7 days (range, 1 to 122 days). In-hospital mortality was 8%. Overall, median cost per patient was 26 326 New Taiwan dollars (NTD) (original currency) or $841; median cost per day was 3777 NTD or $121. Median costs for patients with initial NIHSS score 0 to 6, 7 to 15, and 16 to 38 were 20 365 NTD ($650), 31 954 NTD ($1020), and 62 653 NTD ($2000), respectively. Daily component (physician and ward charges) accounted for approximately 38% of total costs. Initial NIHSS score, small-vessel occlusion, admission to intensive care unit, sex, and smoking had significant impacts on costs. Conclusions— Apart from providing cost estimates, we note that stroke severity strongly affects costs.