COST OF ACUTE STROKE CARE IN TORONTO, CANADA

Background and Purpose Stroke cost consumes a large proportion of the gross domestic product in all developed countries, and while health ca re costs are rising, the ability to contain them is diminishing. Metho ds We calculated the cost of acute stroke care for all first admission s to a teaching hospital in Toronto, Canada, in 1991 through 1992 for 285 consecutive patients. Results The average cost per patient was $27 500 Canadian, and strokes in men cost less than in women ($23 000 ver sus $32 000 Canadian), for a total cost of $8 million Canadian over 2 years. More women died than men (34% versus 17%, P<.02), mainly from s ystemic complications of stroke, but because women stayed hospitalized longer, they cost more in the long term. The major factor determining cost was social support, and more men than women went home or to reha bilitation units (P<.02). Family support was greater for men (82%) tha n women (39%, P<.0002). Conclusions Significant cost reductions are mo re likely to be achieved by altering discharge policies and improving social conditions for early return to the home than by reducing labora tory or medical personnel costs.