EPIDEMIOLOGICAL BURDEN, HEALTHCARE RESOURCE UTILIZATION, AND SURVIVAL AMONG PATIENTS WITH ACUTE ISCHEMIC STROKE IN THE BRAZILIAN PRIVATE HEALTH SYSTEM: A REAL-WORLD RETROSPECTIVE COHORT
Author(s)
Kathiaja Miranda Souza, PhD1, Magali Caregatti, MBA2, Robson Bruniera de Oliveira, PhD2, Fernandes Taís Bertoldo Teixeira, MBA2.
1Boehringer Ingelheim, São Paulo, Brazil, 2Orizon Healthtech, São Paulo, Brazil.
1Boehringer Ingelheim, São Paulo, Brazil, 2Orizon Healthtech, São Paulo, Brazil.
OBJECTIVES: Acute ischemic stroke (AIS) is a leading cause of death and acquired disability, imposing growing clinical and economic pressure on health systems. We characterized the real-world epidemiology, resource utilization, and survival of AIS patients in the Brazilian private health system.
METHODS: Retrospective cohort using an administrative billing database of a private company (Orizon), representative of the Brazilian private health system (~8.8 million covered lives in 2024). Beneficiaries with AIS (ICD-10 I63, I64, I65, I66) were identified between January 2018 and December 2024 and followed through March 2025. Epidemiological measures, healthcare resource utilization (emergency visits, hospital admissions, length of stay, intensive care unit [ICU] use, rehabilitation), and survival (Kaplan-Meier) were analyzed.
RESULTS: 31,682 beneficiaries were included; period prevalence was 520 per 100,000. Sex and age were available for 18,793 patients (59% of the cohort). Within this descriptive subset, 51% were male, 49% female; patients aged ≥65 years represented 52.2%, including 21.2% aged ≥80 years. The Southeast held 68% of cases, while the Northeast had the highest prevalence rate (173 per 100,000). Only 3.7% (1,157) received thrombolysis, indicating low reperfusion-therapy penetration. Resource use was intensive: 86.6% had ≥1 emergency visit and 86.5% progressed to hospitalization; across ~76,000 admissions, mean length of stay was 28.9 days, 74% required ICU (mean 36.8 days), and 44.7% underwent rehabilitation within 90 days. Overall survival was 86.2% over the available follow-up period. Survival probability decreased progressively over time and was consistently lower in older age groups, with the most pronounced reductions observed among patients aged 80 years or older.
CONCLUSIONS: AIS in the Brazilian private health system was associated with substantial resource use and higher early mortality after the index event. Low thrombolysis use suggests potential gaps in acute-phase care and supports further investigation into reperfusion access and post-stroke care pathways.
METHODS: Retrospective cohort using an administrative billing database of a private company (Orizon), representative of the Brazilian private health system (~8.8 million covered lives in 2024). Beneficiaries with AIS (ICD-10 I63, I64, I65, I66) were identified between January 2018 and December 2024 and followed through March 2025. Epidemiological measures, healthcare resource utilization (emergency visits, hospital admissions, length of stay, intensive care unit [ICU] use, rehabilitation), and survival (Kaplan-Meier) were analyzed.
RESULTS: 31,682 beneficiaries were included; period prevalence was 520 per 100,000. Sex and age were available for 18,793 patients (59% of the cohort). Within this descriptive subset, 51% were male, 49% female; patients aged ≥65 years represented 52.2%, including 21.2% aged ≥80 years. The Southeast held 68% of cases, while the Northeast had the highest prevalence rate (173 per 100,000). Only 3.7% (1,157) received thrombolysis, indicating low reperfusion-therapy penetration. Resource use was intensive: 86.6% had ≥1 emergency visit and 86.5% progressed to hospitalization; across ~76,000 admissions, mean length of stay was 28.9 days, 74% required ICU (mean 36.8 days), and 44.7% underwent rehabilitation within 90 days. Overall survival was 86.2% over the available follow-up period. Survival probability decreased progressively over time and was consistently lower in older age groups, with the most pronounced reductions observed among patients aged 80 years or older.
CONCLUSIONS: AIS in the Brazilian private health system was associated with substantial resource use and higher early mortality after the index event. Low thrombolysis use suggests potential gaps in acute-phase care and supports further investigation into reperfusion access and post-stroke care pathways.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH161
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)