OBJECTIVES

The aim of this study was to estimate patients’ productivity losses and informal care costs during the first year after ischemic stroke (IS) in Rhône area, France.

METHODS

A cross-sectional survey was performed along with the STROKE69 cohort study, which a regional multicenter registry. Two questionnaires were mailed, one intended for all IS patients and the second for their main informal caregiver. The Human Capital Approach was used to estimate patients’ productivity losses (absenteeism and presenteeism) and the Proxy Good Method for informal care costs.

RESULTS

Two hundred twenty-two IS patients returned complete questionnaires (58% men; mean age 68y; 86% with mRS<3 at 3 months). Fifty-four per cent received informal care, 32% formal care and 26% both. A hundred and twelve main informal caregivers answered to their specific questionnaire mainly women (64%). The majority lived with the patient (73%) and 57% were retired or unemployed. The mean informal care hours per week was 25 and increased with the mRS level at 3 months. The total mean cost of informal care was estimated at €10,634 ± 17,299 per caregiver. For an active patient, mean productivity losses were estimated at €22,460 ± 15,671 (including 7% of presenteeism). Sixty-one per cent returned to work with a mean delay of 97 ± 96 days. For an unemployed or a retired patient, productivity losses were estimated at €3,240 ± 4,125 (including 57% of presenteeism).

CONCLUSIONS

The present study is the first to value productivity loss of retired or unemployed IS patients. Informal care and IS patients’ productivity losses during the first year represent an economic impact for society compared to direct costs. As a result, these costs should be included more broadly in economic evaluations adopting societal perspective to avoid underestimating the cost of diseases which induce disabilities.