Estimating the Burden of Stroke: Two-Year Societal Costs and Generic Health-Related Quality of Life of the Restore4Stroke Cohort

Ghislaine van Mastrigt; Caroline van Heugten; Anne Visser-Meily; Leonarda Bremmers; Silvia Evers

doi:10.3390/ijerph191711110

Estimating the Burden of Stroke: Two-Year Societal Costs and Generic Health-Related Quality of Life of the Restore4Stroke Cohort

Ghislaine van Mastrigt^*, Caroline van Heugten, Anne Visser-Meily, Leonarda Bremmers, Silvia Evers

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

(1) Background: This study aimed to investigate two-year societal costs and generic health-related quality of life (QoL) using a bottom-up approach for the Restore4Stroke Cohort. (2) Methods: Adult post-stroke patients were recruited from stroke units throughout the Netherlands. The societal costs were calculated for healthcare and non-healthcare costs in the first two years after stroke. The QoL was measured using EQ-5D-3L. The differences between (sub)groups over time were investigated using a non-parametric bootstrapping method. (3) Results: A total of 344 post-stroke patients were included. The total two-year societal costs of a post-stroke were EUR 47,502 (standard deviation (SD = EUR 2628)). The healthcare costs decreased by two thirds in the second year -EUR 14,277 (95% confidence interval -EUR 17,319, -EUR 11,236). In the second year, over 50% of the total societal costs were connected to non-healthcare costs (such as informal care, paid help, and the inability to perform unpaid labor). Sensitivity analyses confirmed the importance of including non-healthcare costs for long-term follow-up. The subgroup analyses showed that patients who did not return home after discharge, and those with moderate to severe stroke symptoms, incurred significantly more costs compared to patients who went directly home and those who reported fewer symptoms. QoL was stable over time except for the stroke patients over 75 years of age, where a significant and clinically meaningful decrease in QoL over time was observed. (4) Conclusions: The non-healthcare costs have a substantial impact on the first- and second-year total societal costs post-stroke. Therefore, to obtain a complete picture of all the relevant costs related to a stroke, a societal perspective with a follow-up of at least two years is highly recommended. Additionally, more research is needed to investigate the decline in QoL found in stroke patients above the age of 75 years.

Original language	English
Article number	11110
Number of pages	15
Journal	International Journal of Environmental Research and Public Health
Volume	19
Issue number	17
DOIs	https://doi.org/10.3390/ijerph191711110
Publication status	Published - 5 Sept 2022

Keywords

Adult
Aged
Cohort Studies
Cost of Illness
Health Care Costs
Humans
Patient Care
Quality of Life
Stroke/therapy

Access to Document

10.3390/ijerph191711110Licence: CC BY

Cite this

@article{1af793e2e947487982ddab5ae3bec576,

title = "Estimating the Burden of Stroke: Two-Year Societal Costs and Generic Health-Related Quality of Life of the Restore4Stroke Cohort",

abstract = "(1) Background: This study aimed to investigate two-year societal costs and generic health-related quality of life (QoL) using a bottom-up approach for the Restore4Stroke Cohort. (2) Methods: Adult post-stroke patients were recruited from stroke units throughout the Netherlands. The societal costs were calculated for healthcare and non-healthcare costs in the first two years after stroke. The QoL was measured using EQ-5D-3L. The differences between (sub)groups over time were investigated using a non-parametric bootstrapping method. (3) Results: A total of 344 post-stroke patients were included. The total two-year societal costs of a post-stroke were EUR 47,502 (standard deviation (SD = EUR 2628)). The healthcare costs decreased by two thirds in the second year -EUR 14,277 (95% confidence interval -EUR 17,319, -EUR 11,236). In the second year, over 50% of the total societal costs were connected to non-healthcare costs (such as informal care, paid help, and the inability to perform unpaid labor). Sensitivity analyses confirmed the importance of including non-healthcare costs for long-term follow-up. The subgroup analyses showed that patients who did not return home after discharge, and those with moderate to severe stroke symptoms, incurred significantly more costs compared to patients who went directly home and those who reported fewer symptoms. QoL was stable over time except for the stroke patients over 75 years of age, where a significant and clinically meaningful decrease in QoL over time was observed. (4) Conclusions: The non-healthcare costs have a substantial impact on the first- and second-year total societal costs post-stroke. Therefore, to obtain a complete picture of all the relevant costs related to a stroke, a societal perspective with a follow-up of at least two years is highly recommended. Additionally, more research is needed to investigate the decline in QoL found in stroke patients above the age of 75 years.",

keywords = "Adult, Aged, Cohort Studies, Cost of Illness, Health Care Costs, Humans, Patient Care, Quality of Life, Stroke/therapy",

author = "{van Mastrigt}, Ghislaine and {van Heugten}, Caroline and Anne Visser-Meily and Leonarda Bremmers and Silvia Evers",

note = "Funding Information: This work research was funded by the VSBfund (Dutch organization for supporting Dutch society with money, knowledge and networks, PO Box 16, 3500 AA, Utrecht, The Netherlands, project number 60-61300-98-022), the Dutch Heart Foundation (PO Box 300 2501 CH Den Haag, the Netherlands) and coordinated by Zon-Mw (Dutch Organisation for Health Research and Development). The funding bodies were not involved in the design of the study, collection, analysis, interpretation of data, or writing of the manuscript. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = sep,

day = "5",

doi = "10.3390/ijerph191711110",

language = "English",

volume = "19",

journal = "International Journal of Environmental Research and Public Health",

issn = "1660-4601",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "17",

}

Estimating the Burden of Stroke: Two-Year Societal Costs and Generic Health-Related Quality of Life of the Restore4Stroke Cohort. / van Mastrigt, Ghislaine ; van Heugten, Caroline; Visser-Meily, Anne et al.
In: International Journal of Environmental Research and Public Health, Vol. 19, No. 17, 11110, 05.09.2022.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Estimating the Burden of Stroke: Two-Year Societal Costs and Generic Health-Related Quality of Life of the Restore4Stroke Cohort

AU - van Mastrigt, Ghislaine

AU - van Heugten, Caroline

AU - Visser-Meily, Anne

AU - Bremmers, Leonarda

AU - Evers, Silvia

N1 - Funding Information: This work research was funded by the VSBfund (Dutch organization for supporting Dutch society with money, knowledge and networks, PO Box 16, 3500 AA, Utrecht, The Netherlands, project number 60-61300-98-022), the Dutch Heart Foundation (PO Box 300 2501 CH Den Haag, the Netherlands) and coordinated by Zon-Mw (Dutch Organisation for Health Research and Development). The funding bodies were not involved in the design of the study, collection, analysis, interpretation of data, or writing of the manuscript. Publisher Copyright: © 2022 by the authors.

PY - 2022/9/5

Y1 - 2022/9/5

N2 - (1) Background: This study aimed to investigate two-year societal costs and generic health-related quality of life (QoL) using a bottom-up approach for the Restore4Stroke Cohort. (2) Methods: Adult post-stroke patients were recruited from stroke units throughout the Netherlands. The societal costs were calculated for healthcare and non-healthcare costs in the first two years after stroke. The QoL was measured using EQ-5D-3L. The differences between (sub)groups over time were investigated using a non-parametric bootstrapping method. (3) Results: A total of 344 post-stroke patients were included. The total two-year societal costs of a post-stroke were EUR 47,502 (standard deviation (SD = EUR 2628)). The healthcare costs decreased by two thirds in the second year -EUR 14,277 (95% confidence interval -EUR 17,319, -EUR 11,236). In the second year, over 50% of the total societal costs were connected to non-healthcare costs (such as informal care, paid help, and the inability to perform unpaid labor). Sensitivity analyses confirmed the importance of including non-healthcare costs for long-term follow-up. The subgroup analyses showed that patients who did not return home after discharge, and those with moderate to severe stroke symptoms, incurred significantly more costs compared to patients who went directly home and those who reported fewer symptoms. QoL was stable over time except for the stroke patients over 75 years of age, where a significant and clinically meaningful decrease in QoL over time was observed. (4) Conclusions: The non-healthcare costs have a substantial impact on the first- and second-year total societal costs post-stroke. Therefore, to obtain a complete picture of all the relevant costs related to a stroke, a societal perspective with a follow-up of at least two years is highly recommended. Additionally, more research is needed to investigate the decline in QoL found in stroke patients above the age of 75 years.

AB - (1) Background: This study aimed to investigate two-year societal costs and generic health-related quality of life (QoL) using a bottom-up approach for the Restore4Stroke Cohort. (2) Methods: Adult post-stroke patients were recruited from stroke units throughout the Netherlands. The societal costs were calculated for healthcare and non-healthcare costs in the first two years after stroke. The QoL was measured using EQ-5D-3L. The differences between (sub)groups over time were investigated using a non-parametric bootstrapping method. (3) Results: A total of 344 post-stroke patients were included. The total two-year societal costs of a post-stroke were EUR 47,502 (standard deviation (SD = EUR 2628)). The healthcare costs decreased by two thirds in the second year -EUR 14,277 (95% confidence interval -EUR 17,319, -EUR 11,236). In the second year, over 50% of the total societal costs were connected to non-healthcare costs (such as informal care, paid help, and the inability to perform unpaid labor). Sensitivity analyses confirmed the importance of including non-healthcare costs for long-term follow-up. The subgroup analyses showed that patients who did not return home after discharge, and those with moderate to severe stroke symptoms, incurred significantly more costs compared to patients who went directly home and those who reported fewer symptoms. QoL was stable over time except for the stroke patients over 75 years of age, where a significant and clinically meaningful decrease in QoL over time was observed. (4) Conclusions: The non-healthcare costs have a substantial impact on the first- and second-year total societal costs post-stroke. Therefore, to obtain a complete picture of all the relevant costs related to a stroke, a societal perspective with a follow-up of at least two years is highly recommended. Additionally, more research is needed to investigate the decline in QoL found in stroke patients above the age of 75 years.

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Cost of Illness

KW - Health Care Costs

KW - Humans

KW - Patient Care

KW - Quality of Life

KW - Stroke/therapy

U2 - 10.3390/ijerph191711110

DO - 10.3390/ijerph191711110

M3 - Article

C2 - 36078828

SN - 1660-4601

VL - 19

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 17

M1 - 11110

ER -