Conflict of interest: The authors have no conflict of interest.
Population-based study of acute- and long-term care costs after stroke in patients with AF
Article first published online: 9 MAY 2012
© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization
International Journal of Stroke
Volume 8, Issue 5, pages 308–314, July 2013
How to Cite
Luengo-Fernandez, R., Yiin, G. S.C., Gray, A. M. and Rothwell, P. M. (2013), Population-based study of acute- and long-term care costs after stroke in patients with AF. International Journal of Stroke, 8: 308–314. doi: 10.1111/j.1747-4949.2012.00812.x
Funding: Ramon Luengo-Fernandez is funded from an Economic and Social Research Council/Medical Research Council/National Institute for Health Research (NIHR) early career fellowship in economics of health. Additional financial support for the analysis presented in this study was received from an unrestricted educational grant from Boehringer Ingelheim. Oxford Vascular Study is funded by the UK Medical Research Council, the Dunhill Medical Trust, the Stroke Association, the BUPA Foundation, the NIHR, the Thames Valley Primary Care Research Partnership, and the NIHR Biomedical Research Centre, Oxford. HERC obtains part of its funding from the NIHR.
- Issue published online: 20 JUN 2013
- Article first published online: 9 MAY 2012
- National Institute for Health Research (NIHR)
- Boehringer Ingelheim
- UK Medical Research Council
- Dunhill Medical Trust
- Stroke Association
- BUPA Foundation
- Thames Valley Primary Care Research Partnership
- NIHR Biomedical Research Centre
- atrial fibrillation;
- cost factors;
- resource use;
New treatments for atrial fibrillation patients have been shown to be effective at reducing subsequent vascular event recurrence. However, there are few data on stroke costs in atrial fibrillation patients to allow the cost-effectiveness of these treatments to be assessed.
Using data from a population-based study, we assessed the acute and long-term costs of stroke in atrial fibrillation patients.
Health-care costs one-year before and five-years after stroke were obtained from a large population-based study (Oxford Vascular study). Costs were assessed for the three-months poststroke (acute period) and annually thereafter (postacute period). Annual postacute costs were compared with annual baseline costs. Based on patients' living arrangements, costs of institutionalization after the event were included.
A total of 191 strokes occurred in 153 patients with known prior atrial fibrillation. Mean health-care costs after stroke were £10 413 (standard deviation 15 105) in the acute phase, with annual postacute health-care costs nonsignificantly smaller than those incurred before the event (£2400 vs. £3356, respectively; P = 0·198). However, for the 136 strokes surviving past the 90-day acute period, costs were nonsignificantly higher than those incurred in the year before the event (£3370 vs. £2566, respectively; P = 0·333). After stroke, 25 (13%) patients were newly admitted into long-term warden, nursing, or residential care, resulting in annual costs of £6880 (standard deviation 15 600) averaged across the 136 stroke cases surviving past the acute period.
Although annual post acute phase hospital and primary health-care costs in stroke patients with prior atrial fibrillation were not significantly different to those incurred before the stroke, long-term nursing/residential care costs were substantial.