Cost of spontaneous intracerebral hemorrhage in Canada during 1 decade.

Abstract

Spontaneous intracerebral hemorrhage (ICH) is widely considered to be the most devastating form of stroke in North America. Currently there is no clear understanding of the cost of treatment in Canada and thus no way of understanding how to manage ICH spending in this country. We used a cohort study design to report and to examine the cost of ICH hospital care in a Canadian health center during 1 decade. Economic, treatment, and patients data were obtained from clinical and administrative sources. Analyses were performed using 987 consecutive patients with ICH from 1999 to 2008. The total inflation-adjusted cost of care was highly variable (median cost per discharge, $10,544.45 and $363.54 [min] to $265 470.43 [max] United States Dollars). Total cost did not change significantly during the decade. Patients age (cost change per year older, -$114.06 and -$189.01 to -$38.78) and in-hospital mortality (cost change for death, -$5092.84 and -$6270.65 to -$3697.09) were significantly associated with lower cost, whereas Charlson Comorbidity Index (cost change for ≥1, $5726.27 and $3965.36 to $7755.45), having surgery (cost change for surgery, $25,499.78 and $20,813.95 to $30,933.06), and admission National Institutes of Health Stroke Scale (cost change for ≥15 points, $7800.20 and $1637.78 to $17,026.38) were significantly associated with higher cost. To our knowledge, this is the most thorough published study to date to report and to examine predictors of ICH treatment costs in Canada. This study provides evidence that it may be reasonable to consider patients age, probability of death, level of comorbidity, need for surgery, and baseline ICH severity when forecasting health spending.