Cost of stroke in Australia from a societal perspective - Results from theNorth East Melbourne Stroke Incidence Study (NEMESIS)

Background and Purpose-Accurate information about resource use and costs of stroke is necessary for informed health service planning. The purpose of t his study was to determine the patterns of resource use among stroke patien ts and to estimate the total costs (direct service use and indirect product ion losses) of stroke (excluding SAH) in Australia for 1997. Methods-An incidence-based cost-of-illness model was developed, incorporati ng data obtained from the North East Melbourne Stroke Incidence Study (NEME SIS). The costs of stroke during the first year after stroke and the presen t value of total lifetime costs of stroke were estimated. Results-The total first-year costs of all first-ever-in-a lifetime strokes (SAH excluded) that occurred in Australia during 1997 were estimated to be A$555 million (US$420 million), and the present value of lifetime costs was estimated to be A$1.3 billion (US$985 million). The average cost per case during the first 12 months and over a lifetime was A$18 956 (US$14 361) and A$44 428 (US$33 658), respectively. The most important categories of cost during the first year were acute hospitalization (A$154 million), inpatient rehabilitation (A$150 million), and nursing home care (A$63 million). The present value of lifetime indirect costs was estimated to be A$34 million. Conclusions-Similar to other studies, hospital and nursing home costs contr ibuted most to the total cost of stroke (excluding SAH) in Australia. Inpat ient rehabilitation accounts for approximate to 27% of total first-year cos ts. Given the magnitude of these costs, investigation of the cost-effective ness of rehabilitation services should become a priority in this community.