The iScore predicts total healthcare costs early after hospitalization for an acute ischemic stroke

被引:4
作者
Ewara, Emmanuel M. [1 ]
Isaranuwatchai, Wanrudee [1 ,2 ]
Bravata, Dawn M. [3 ,4 ,5 ,6 ,7 ]
Williams, Linda S. [3 ,4 ,6 ,7 ]
Fang, Jiming [8 ]
Hoch, Jeffrey S. [1 ,2 ,8 ]
Saposnik, Gustavo [9 ,10 ]
机构
[1] St Michaels Hosp, Ctr Excellence Econ Anal Res, Li Ka Shing Knowledge Inst, Toronto, ON M5C 1R6, Canada
[2] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[3] Stroke Qual Enhancement Res Initiat QUERI, VHA Hlth Serv Res & Dev HSR&D, Washington, DC USA
[4] VHA HSR&D Ctr Innovat Hlth Informat & Commun, Indianapolis, IN USA
[5] Indiana Univ Sch Med, Dept Internal Med, Indianapolis, IN 46202 USA
[6] Indiana Univ Sch Med, Dept Neurol, Indianapolis, IN 46202 USA
[7] Regenstrief Inst Hlth Care, Indianapolis, IN 46202 USA
[8] Inst Clin Evaluat Sci, Toronto, ON, Canada
[9] Univ Toronto, Sch Med, Dept Neurol, Toronto, ON, Canada
[10] St Michaels Hosp, Div Neurol, Toronto, ON M5C 1R6, Canada
关键词
cost; outcomes; risk scores; stroke; stroke management; IMPACT;
D O I
10.1111/ijs.12641
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background The ischemic Stroke risk score is a validated prognostic score which can be used by clinicians to estimate patient outcomes after the occurrence of an acute ischemic stroke. Aim In this study, we examined the association between the ischemic Stroke risk score and patients' 30-day, one-year, and two-year healthcare costs from the perspective of a third party healthcare payer. Methods Patients who had an acute ischemic stroke were identified from the Registry of Canadian Stroke Network. The 30-day ischemic Stroke risk score prognostic score was determined for each patient. Direct healthcare costs at each time point were determined using administrative databases in the province of Ontario. Unadjusted mean and the impact of a 10-point increase ischemic Stroke risk score and a patient's risk of death or disability on total cost were determined. Results There were 12 686 patients eligible for the study. Total unadjusted mean costs were greatest among patients at high risk. When adjusting for patient characteristics, a 10-point increase in the ischemic Stroke risk score was associated with 8%, 7%, and 4% increase in total costs at 30 days, one-year, and two-years. The same increase was found to impact patients at low, medium, and high risk differently. When adjusting for patient characteristics, patients in the high-risk group had the highest total costs at 30 days, while patients at medium risk had the highest costs at both one and two-years. Conclusions The ischemic Stroke risk score can be useful as a predictor of healthcare utilization and costs early after hospitalization for an acute ischemic stroke.
引用
收藏
页码:1179 / 1186
页数:8
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