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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Social and economic costs and health-related quality of life in stroke survivors in the Canary Islands, Spain

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Julio Lopez-Bastida, Juan Oliva Moreno, Melany Worbes Cerezo, Lilisbeth Perestelo Perez, Pedro Serrano-Aguilar, Fernando Montón-Álvarez
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JLP and JOM conceived and designed the research, acquired the data, analyzed and interpreted the data, performed the statistical analyses, handled funding and supervision, drafted the manuscript and critically revised the manuscript for important intellectual content. MWC acquired the data, analyzed and interpreted the data, performed statistical analyses and critically revised the manuscript for important intellectual content. LPP conceived and designed the research, analyzed and interpreted the data, performed statistical analyses and drafted the manuscript. PSA conceived and designed the research, acquired the data, analyzed and interpreted the data, drafted the manuscript and critically revised the manuscript for important intellectual content. FMA conceived and designed the research, acquired the data, analyzed and interpreted the data and critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Abstract

Background

Cost-of-illness analysis is the main method of providing an overall vision of the economic impact of a disease. Such studies have been used to set priorities for healthcare policies and inform resource allocation. The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) in the first, second and third years after surviving a stroke in the Canary Islands, Spain.

Methods

Cross-sectional, retrospective study of 448 patients with stroke based on ICD 9 discharge codes, who received outpatient care at five hospitals. The study was approved by the Research Ethics Committee of Nuestra Señora de la Candelaria University Hospital. Data on demographic characteristics, health resource utilization, informal care, labor productivity losses and HRQOL were collected from the hospital admissions databases and questionnaires completed by stroke patients or their caregivers. Labor productivity losses were calculated from physical units and converted into monetary units with a human capital-based method. HRQOL was measured with the EuroQol EQ-5D questionnaire. Healthcare costs, productivity losses and informal care costs were analyzed with log-normal, probit and ordered probit multivariate models.

Results

The average cost for each stroke survivor was €17 618 in the first, €14 453 in the second and €12 924 in the third year after the stroke; the reference year for unit prices was 2004. The largest expenditures in the first year were informal care and hospitalizations; in the second and third years the main costs were for informal care, productivity losses and medication. Mean EQ-5D index scores for stroke survivors were 0.50 for the first, 0.47 for the second and 0.46 for the third year, and mean EQ-5D visual analog scale scores were 56, 52 and 55, respectively.

Conclusions

The main strengths of this study lie in our bottom-up-approach to costing, and in the evaluation of stroke survivors from a broad perspective (societal costs) in the first, second and third years after surviving the stroke. This type of analysis is rare in the Spanish context. We conclude that stroke incurs considerable societal costs among survivors to three years and there is substantial deterioration in HRQOL.
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