OBJECTIVES: To estimate the 1-year direct and indirect costs of ischemic stroke in Chinese patients with atrial fibrillation (AF). METHODS: A cost-of-illness study was conducted through hospital chart review and a patient follow up survey. Costs were estimated from the societal perspective. Three hundred hospital charts from 12 tier-3 hospitals and 6 tier-2 hospitals in 6 cities across China were randomly selected and reviewed for cost of stroke during hospitalization from patients discharged from January, 2009 to December, 2010 (discharge diagnosis of both, ischemic stroke and AF). Of those, 50 patients were followed up to collect the long-term direct and indirect costs related to ischemic stroke in the year following discharge. RESULTS: We report here results from two hospitals (N=30): patients had a mean age of 75 years and mean length of stay of 16 days (95%CI= [14, 19]). Females accounted for 43%. The mean time interval between stroke onset and hospitalization was 24 hours (95%CI= [14, 33]). The cohort scored on average 3 points (95%CI= [2, 4]) on the CHA2DS2-VASc, indicating a high risk of stroke considering patient demographics and disease history. Average total 1-year costs of stroke management were estimated at 19,560.01 RMB (2010 costs; 4951.90 US$), almost all of which was attributable to direct costs. Costs of inpatient care dominated direct costs, representing 90.3% of the total direct costs. Average total costs during hospitalization were estimated at 17,659.31 RMB (95%CI= [13,538.39, 21,780.23]), 62.5% of which was attributable to medication. CONCLUSIONS: The findings indicate that ischemic stroke among AF patients are associated with high direct costs, imposing a considerable burden on society. Hospital costs are the predominant contributor, consistent with the current pattern of care in China, where patient care is usually provided via hospitals.
Wu, J., Yang, L., & Zhu, G. (2013). The economic burden of atrial fibrillation -related stroke in China. Value in Health, 16(3), A281–A282. https://doi.org/10.1016/j.jval.2013.03.1459