The Cost of Intracerebral Haemorrhage: A Canadian Example

Purpose: Primary Intracerebral Haemorrhage (ICH) is one of the most devastating forms of stroke with substantial morbidity and mortality. Although the human cost of ICH has been reported frequently, the economic cost of ICH is still unclear. This study reports on the economic cost of ICH over two consecutive years at three centers in Calgary, Alberta Canada. Methods: Cost data was derived from hospital and physician claims for patients who were treated for primary ICH at three hospitals in Calgary Alberta for the 1999–2000 and 2000–2001 fiscal years. ICH was defined as one event and cost was calculated from the time the patients were admitted to the time they were discharged from hospital or died. All cost data is reported in Canadian dollars and is calculated for the year the event occurred. Mean comparison tests were used to assess the difference in days spent in hospital, inpatient cost and non-physician health care cost between those that survived and those that died. Results: The sample included 114 patients; 58 in 1999/00 and 56 in 2000/01. The average cost of ICH was $17,325.67 (95% CI = $13,004.80–$21,646.55) per patient regardless of whether they survived or died. Those who survived were in hospital for significantly more days (p<0.001, mean = 28.6 days, 95%CI = 21.1–36.0 days) compared to those who died (mean = 5.5 days, 95%CI = 3.2–7.8 days). Those who survived incurred significantly more total health care costs (p<0.001, mean = $24,670.20, 95% CI = $18,179.19–$31,161.21) compared to those who died (mean = $6,064.01, 95% CI = $3,940.47– $8,187.68). Specifically, those who survived incurred significantly more non-physician health care costs (p<0.001, mean = $23,550.04, 95% CI = $17,370.81– $29,729.28) compared to those who died (mean = $4,472.41, 95%CI = $2,625.10– $6,319.71). Conclusion: The cost of ICH is substantial. Patients who survive ICH incur the most health care cost likely because they spend more time in hospital. Future treatment strategies focused on reducing the morbidity associated with ICH may be important in reducing the economic cost. [Copyright &y& Elsevier]