Costs of acute care of first-ever ischemic stroke in Taiwan.

BACKGROUND AND PURPOSE We sought to investigate the direct costs of acute hospitalization for patients with first-ever ischemic stroke in Taiwan. METHODS Data were prospectively collected from 360 first-ever ischemic stroke patients. Hospital charges were used for analysis. Multiple linear regression analysis was used to identify the main factors influencing costs. RESULTS Mean age was 64.9 years (median, 67.0 years), and 58% were male. Mean National Institutes of Health Stroke Scale (NIHSS) score at admission was 9.4 (median, 6.0). Mean initial score of modified Barthel Index was 10.7 (median, 12.0). Median length of stay was 7 days (range, 1 to 122 days). In-hospital mortality was 8%. Overall, median cost per patient was 26 326 New Taiwan dollars (NTD) (original currency) or 841 dollars; median cost per day was 3777 NTD or 121 dollars. Median costs for patients with initial NIHSS score 0 to 6, 7 to 15, and 16 to 38 were 20 365 NTD (650 dollars), 31 954 NTD (1020 dollars), and 62 653 NTD (2000 dollars), respectively. Daily component (physician and ward charges) accounted for approximately 38% of total costs. Initial NIHSS score, small-vessel occlusion, admission to intensive care unit, sex, and smoking had significant impacts on costs. CONCLUSIONS Apart from providing cost estimates, we note that stroke severity strongly affects costs.