OBJECTIVES: To estimate the healthcare resource utilization and direct costs of cardioembolic stroke in patients treated in public hospitals of the Region of Madrid (Spain). METHODS: An observational, prospective study was performed in 5 Neurology services from hospitals in the Region of Madrid, 2 with stroke units (SU) and 3 without stroke units (wSU). Patients with a diagnosis of cardioembolic stroke with ≤48-hours were recruited in a 4-month period in 2012. Patients’ socio-demographic, clinical data: disability (modified Rankin scale, mRs), hospital stay and mortality; complications and healthcare resource utilization (hospitalisation, in-patient and at discharge rehabilitation, medication, laboratory tests and specific therapeutic interventions) were collected. Unitary costs were obtained from national healthcare database and the Spanish Catalogue of Medicinal Products (€, year 2012). RESULTS: Preliminary results from 76 patients (25 SU, 51 wSU) were: mean age, 74.2±1.42; 64.5% female; mean mRs at discharge, 2.02±0.20; non-valvular atrial fibrilation was the main cause of cardioembolic stroke (28.9%); mean length of stay, 10.1±1.14 days; mortality, 5.3%; 42 patients (68.4%) needed in-patient rehabilitation and 48 patients (63.2%) needed rehabilitation after hospital discharge; 22 patients (28.9%) suffered hospital complications (63.6% of them suffered infections, 27.3% cardiovascular complications and 59.1% others). Healthcare resource utilization differences between SU and wSU hospitals were found in: length of stay (7.2±1.26 days, SU; 11.6±1.55 days, wSU; p-value=0.014) and specific therapeutic interventions (41.7%, SU; 8.0%, wSU; p-value=0.001). The overall 4-month cost per patient was 13,647€ (49.2%, hospital stay; 24.8%, rehabilitation at discharge). CONCLUSIONS: Cardioembolic stroke imposes significant economic burden for the Public Health System in the Region of Madrid. Key cost drivers were hospital stay and patients’ rehabilitation at discharge. Patient management in SU hospitals was associated with more specific therapeutic interventions and shorter hospital stay than hospitals wSU.