COST OF ACUTE CARE FOR ISCHEMIC STROKE IN THAILAND

Stroke is a leading cause of mortality and morbidity worldwide and has a large economic cost. The hospital associated cost for acute treatment is a major component of the annual cost for stroke. In this study, we aimed to determine the direct medical costs of acute ischemic stroke treatment per patient admitted to a tertiary level government hospital in Bangkok, Thailand and to identify components of and predictors for the costs in order to better estimate the overall cost of stroke in Thailand. We retrospectively reviewed the records and direct medical costs for treatment of 335 patients admitted to the study hospital with ischemic stroke during 2008. Year 2008 prices were used for the study. We used multiple regression analysis to determine factors associated with hospital cost. The mean cost for acute ischemic stroke treatment per patient at the study hospital was 42,400 Thai Baht (USD 1,211). The largest proportion of the cost was for the hospital room and routine services (57%) followed by imaging (23%). The average length of stay was 5.7 days. Multiple linear regression analysis of the natural log of the direct medical cost showed variation in costs were largely attributable to: the Barthel Index on admission, the time of onset of stroke symptoms, stroke unit admission, rtPA usage, development of severe complications, patient history of smoking and to presence of two demographic factors (gender and whether the patient had health insurance or not) (R-square = 0.4135). This study determined the total hospital cost for acute ischemic stroke treatment and the factors associated with this cost. This can provided information to get a better estimate of the overall cost of stroke in Thailand.