Short- and Longer-Term Healthcare Resource Utilization and Related Costs of Stroke in the Brazilian Private Market from 2019 to 2023
Author(s)
Joao Paulo Dos Reis Neto, PhD, MD1, JULIANA BUSCH, MD2;
1Diretor-Presidente da Capesesp, ceo, Rio de Janeiro, Brazil, 2CAPESESP, Rio de Janeiro, Brazil
1Diretor-Presidente da Capesesp, ceo, Rio de Janeiro, Brazil, 2CAPESESP, Rio de Janeiro, Brazil
OBJECTIVES: Stroke is a major cause of mortality and disability worldwide. Understanding the treatment of stroke can guide health policies and interventions, however, few studies have analyzed the costs of stroke in Brazil. The aim of this study is to assess stroke-related healthcare resource utilization (HCRU), costs, mortality and to estimate the Years of Life Lost (YLL).
METHODS: Real-world retrospective database study using data from January/2019 to December/2023. Adults with stroke diagnoses (ICD I-64) were identified. Available data include demographics, comorbidities, HCRU, and costs per year. Kaplan-Meier curves were used to estimate the cumulative survival rates. To calculate YLL we use a Brazilian mortality table to identify the standardized life expectancy, and the number of deaths occurred. Chi-square and Fisher’s exact and Student’s t tests for categorical/continuous measures. Statistical significance for p<0.05.
RESULTS: Of 60,147 beneficiaries (average age 53 years, 59.6% female), 1,398 diagnosed with stroke (77±13 years; 56.5% female). Prevalence was 4.4% in men and 3.9% in women (p<0.05) and increased linearly with advancing age (90.4% aged ≥ 60 years). 94.0% had comorbidities (23% moderate/severe). Rate of procedures per year for visits, emergency room, tests, therapies, and hospitalization were 5.3, 1.9, 68.2, 24.7 and 1.1, respectively. The average length of hospitalization was 12 days. Annualized healthcare costs associated with stroke were U$ 12,305 per/patient (78.1% hospitalizations). Annual hospital readmission rate was 59.7% higher than the standard (p<.005). Cumulative 5-year survival rate 18%. Regarding YLL, the results indicate an average loss of 8.7 years of life.
CONCLUSIONS: In our study stroke has a significant social and economic impact. It is imperative to better understand stroke care continuum costs to face the challenges of economic resource management and review policies aimed at early diagnosis and acute interventions such as Stroke Units, that has the potential to improve clinical outcomes.
METHODS: Real-world retrospective database study using data from January/2019 to December/2023. Adults with stroke diagnoses (ICD I-64) were identified. Available data include demographics, comorbidities, HCRU, and costs per year. Kaplan-Meier curves were used to estimate the cumulative survival rates. To calculate YLL we use a Brazilian mortality table to identify the standardized life expectancy, and the number of deaths occurred. Chi-square and Fisher’s exact and Student’s t tests for categorical/continuous measures. Statistical significance for p<0.05.
RESULTS: Of 60,147 beneficiaries (average age 53 years, 59.6% female), 1,398 diagnosed with stroke (77±13 years; 56.5% female). Prevalence was 4.4% in men and 3.9% in women (p<0.05) and increased linearly with advancing age (90.4% aged ≥ 60 years). 94.0% had comorbidities (23% moderate/severe). Rate of procedures per year for visits, emergency room, tests, therapies, and hospitalization were 5.3, 1.9, 68.2, 24.7 and 1.1, respectively. The average length of hospitalization was 12 days. Annualized healthcare costs associated with stroke were U$ 12,305 per/patient (78.1% hospitalizations). Annual hospital readmission rate was 59.7% higher than the standard (p<.005). Cumulative 5-year survival rate 18%. Regarding YLL, the results indicate an average loss of 8.7 years of life.
CONCLUSIONS: In our study stroke has a significant social and economic impact. It is imperative to better understand stroke care continuum costs to face the challenges of economic resource management and review policies aimed at early diagnosis and acute interventions such as Stroke Units, that has the potential to improve clinical outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD85
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Neurological Disorders