COST OF STROKE IN THE NETHERLANDS FROM A SOCIETAL PERSPECTIVE

Background and Purpose Cerebrovascular disorders are associated with a high level of morbidity and mortality and call for considerable resou rces. The objective of this study was to determine from a societal per spective the medical consumption (direct costs) and productivity losse s (indirect costs) caused by cerebrovascular disorders in the Netherla nds. Methods This study can be characterized as a cost-of-illness stud y based on prevalence data. All data gathered refer to 1993. Cerebrova scular disorders are defined according to the International Classifica tion of Diseases, 9th Revision (ICD-9) classification. Data from medic al registrations and national statistics have been analyzed. For both direct and indirect costs, volume and cost components are presented. T o test the likelihood of the assumptions, a sensitivity analysis was p erformed. Results The cost of cerebrovascular disorders in the Netherl ands in 1993 amounted to 2.5 billion Dutch guilders, of which 1.9 bill ion were spent on medical consumption. It was found that direct costs are generated mainly by the long-term care of inpatients (nursing home s and hospitals). The productivity losses were relatively low in compa rison with other diseases, probably due to the fact that most patients with cerebrovascular disorders are elderly. Conclusions More than 3% of the Dutch annual healthcare budget is spent on patients suffering f rom cerebrovascular disorders. Costs in the future may be influenced b y, among other things, demographic changes, new therapies, and cost-re duction programs introduced by the government.