While costs and outcomes for cerebrovascular events have been estimated for large, university-based medical centers, similar studies in community hospitals are lacking. OBJECTIVE: To compare costs of care, length of stay and mortality for patients with subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), ischemic cerebral infarction (ICI) and transient ischemic attacks (TIA) for patients treated in community teaching (CT) and nonteaching (CNT) hospitals in the U.S. METHODS: A retrospective cohort design was used, employing data from HBSI s national data warehouse from community hospitals. Comparative costs are calculated using a standardized general ledger approach to derive direct and indirect costs. Wilcoxon signed rank tests were used to test for differences in costs and length of stay. Chi-square tests were used to test for differences in mortality. RESULTS: The sample consisted of 1,244 patients treated in 1998 with SAH, 3,633 with ICH, 16,066 with ICI, and 9,276 with TIA from 137 hospitals. Mean costs for inpatient care were $4,058 higher in CT hospitals for SAH, $3,135 for ICH, $434 for ICI and $216 for TIA (p<0.001 for each). Length of stay was 0.48 days longer for SAH patients and 1.5 days longer for ICH patients treated at CT hospitals (p<0.005). There were no significant differences between CT and CNT hospitals for inpatient mortality, severity of illness or risk of mortality for these events. CONCLUSION: Based on unadjusted estimates of costs and mortality rates, patients with CV events treated at CT hospitals may incur higher costs without any apparent benefit in mortality.