AIMS To examine 1) the major drivers of index hospitalization and 3-year post-acute follow-up care, 2) cost for rehabilitation and homecare, and 3) indirect cost from lost productivity after acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). METHODS Retrospective study of adults hospitalized with AIS (n = 811) and ICH (N = 145) between 2003 and 2014. Direct costs standardized to Medicare reimbursement rates were captured for hospitalization and 3-year follow-up or death. Adjusted cost estimates were assessed using generalized linear modeling with gamma distribution. Costs for rehabilitation, home healthcare, and lost productivity were assessed using sets of cost captured through literature review. RESULTS Calculated as mean cost per person: hospitalization $18,154 for AIS and $24,077 for ICH; monthly 3-year aggregate $5138 for AIS and $8172 for ICH; 3-year inpatient rehabilitation $4185 for AIS and $4196 for ICH; homecare $19,728 for AIS and $14,487 for ICH; indirect cost from lost productivity $77,078 for AIS and $56,601 for ICH. Age < 55 years, being non-white, and stroke severity were strongly associated with greater hospitalization cost for AIS and ICH. Hyperlipidemia incurred lower while cancer, coronary artery disease, asthma/chronic obstructive pulmonary disease, heart failure, and anemia incurred higher 3-year aggregate cost for AIS. Cancer and diabetes mellitus incurred higher 3-year aggregate cost for ICH. CONCLUSIONS We provide estimates of direct and indirect costs incurred for acute and continuing post-acute care through a 3-year follow-up period after first-ever AIS and ICH with important comparisons for predictors between index hospitalization and 3-year post-stroke costs.

中文翻译：

---

第一次急性缺血性卒中和脑出血住院后的初始和后续 3 年费用

目的 研究 1) 指数住院和 3 年急性期后随访护理的主要驱动因素，2) 康复和家庭护理的成本，以及 3) 急性缺血性卒中 (AIS) 和脑出血后生产力下降造成的间接成本。 ICH）。方法 对 2003 年至 2014 年间因 AIS（n = 811）和 ICH（N = 145）住院的成人进行回顾性研究。记录了住院和 3 年随访或死亡的标准化为医疗保险报销率的直接成本。使用具有伽马分布的广义线性建模来评估调整后的成本估计。康复、家庭保健和生产力损失的成本是使用通过文献回顾获得的成本集进行评估的。结果 按人均平均成本计算：AIS 的住院费用为 18,154 美元，ICH 的住院费用为 24,077 美元；AIS 的每月 3 年总计 5138 美元，ICH 的 8172 美元；3 年住院康复 AIS 4185 美元，ICH 4196 美元；家庭护理 AIS 为 19,728 美元，ICH 为 14,487 美元；生产力损失的间接成本 AIS 为 77,078 美元，ICH 为 56,601 美元。年龄 < 55 岁、非白人以及卒中严重程度与 AIS 和 ICH 的住院费用增加密切相关。高脂血症发生率较低，而癌症、冠状动脉疾病、哮喘/慢性阻塞性肺疾病、心力衰竭和贫血引起的 AIS 3 年总成本较高。癌症和糖尿病导致 ICH 的 3 年总成本更高。