OBJECTIVES: Determine patient costs after stroke and compare costs between regular care for stroke patients and care organised in stroke services. METHODS: Patient costs after stroke were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Total costs of care per patient for the 6-month follow up were based on medical consumption of 598 patients in six regions consecutively admitted to a hospital after stroke. Care consumption and cost data were collected for hospital, rehabilitation, nursing home, and home care. Care consumption was retrieved from patients' medical records and from patient interviews two and six months after stroke. Unit cost data were collected at participating institutions. RESULTS: We found that the total costs of care per patient for the 6 month follow up after stroke amount to almost €16,000 on average. Costs are dominated by institutional costs and accommodation costs. Patients who die during the acute phase incur less costs. For patients that survive the acute phase, severity of disability, age, gender and place of residence before stroke are the most important determinants of costs, as they influence patients' stroke careers. These determinants of costs also interact. CONCLUSIONS: Stroke care organised in stroke service experiments potentially is more effective than regular care, although large differences in costs were found between the three stroke services. The most efficient stroke service experiment was the one that was most successful in co-ordinating patient flow from hospital to (nursing) home, through capacity planning and efficient discharge procedures. The other experiments suffered from waiting lists for (nursing) home care, leading to "blocked beds" and higher costs of care. The relations found between costs, organisation of care, patient characteristics and disease severity may be applied as building-blocks for DRGs for stroke care.