ABSTRACT

This study was designed to estimate the economic burden of poststroke aphasia in the United States. The economic burden of aphasia was calculated based on three cost factors: medical and healthcare-related expenses, foregone wages from lost labor market activity, and the market value of informal care given within the home. Data from the 2018 National Health Interview Survey (NHIS) were utilized and a pool of stroke survivors with and without poststroke aphasia were identified for the analysis. Stroke survivors in the NHIS sample were matched using 2:1 propensity score matching with poststroke respondents in the 2014 Health and Retirement Survey based on demographic, household, and medical/healthcare characteristics. HRS data were used to calculate medical expenses/healthcare costs, lost wages, and the cost of informal care for each stroke survivor. To determine the cost of poststroke aphasia, respondents with aphasia were matched with those without aphasia and the calculated cost differential was attributed to be from aphasia. The average cost of medical/healthcare expenditures, lost wages, and informal caregiving for individuals with poststroke aphasia was estimated to be $30,599.78. Individuals with similar demographic characteristics, health status, age, and chronic comorbidities but without aphasia averaged only $24,276.33. The differential cost between PWA and those without aphasia was $6,323.45 – the estimated annual economic burden of aphasia. Given that 2.5 million people in the United States suffer from aphasia, these estimates extrapolated to the general population of individuals with aphasia would correspond to $15.8 billion annually. In recent years, a variety of studies and figures relating the cost of illness have been generated across a variety of conditions. This study marks the first attempts to estimate the economic burden of aphasia and follows the framework recommended by the CDC’s Economic Impact Analysis. While changes in public health and social support policies have begun to recognize the economic burden of informal caregiving, they often fail to consider the magnitude of lost workforce productivity. Our estimates reinforce the high economic burden of stroke in the United States, acknowledging three categories of related costs. While these estimates provide up-to-date information for policy development and decision-making, additional research is needed into the costs of aphasia and the economic benefits of treatment.

摘要

本研究旨在评估美国中风后失语症的经济负担。失语症的经济负担是根据三个成本因素计算得出的：医疗和保健相关费用、因失去劳动力市场活动而放弃的工资以及在家中提供的非正式护理的市场价值。使用了 2018 年全国健康访谈调查 (NHIS) 的数据，并确定了一组有和没有中风后失语症的中风幸存者进行分析。NHIS 样本中的中风幸存者使用 2:1 倾向得分与 2014 年健康和退休调查中基于人口统计、家庭和医疗/医疗保健特征的中风后受访者进行匹配。HRS 数据用于计算每个中风幸存者的医疗费用/医疗保健费用、工资损失和非正式护理费用。为确定中风后失语症的成本，将患有失语症的受访者与没有失语症的受访者进行匹配，并将计算出的成本差异归因于失语症。中风后失语症患者的医疗/保健支出、工资损失和非正式护理的平均成本估计为 30,599.78 美元。具有相似人口特征、健康状况、年龄和慢性合并症但没有失语症的人平均只有 24,276.33 美元。PWA 和没有失语症的人之间的差异成本为 6,323.45 美元——失语症的估计年度经济负担。鉴于美国有 250 万人患有失语症，这些估计值外推到失语症患者的总人口将相当于每年 158 亿美元。最近几年，在各种情况下产生了与疾病成本相关的各种研究和数据。这项研究标志着首次尝试估计失语症的经济负担，并遵循疾病预防控制中心经济影响分析推荐的框架。虽然公共卫生和社会支持政策的变化已经开始认识到非正式护理的经济负担，但他们往往没有考虑劳动力生产力损失的严重程度。我们的估计加强了美国中风的高经济负担，承认三类相关费用。虽然这些估计为政策制定和决策提供了最新信息，但还需要对失语症的成本和治疗的经济效益进行更多研究。