Hospitalization and post-discharge expenses of stroke in Iran: A retrospective cohort study

Abstract

Background: Stroke claims about 5.5 million lives annually, making it the second leading cause of death worldwide. In the United States (US), it is the fifth leading cause, trailing behind cardiovascular diseases (CVD) and cancer.

Methods: This retrospective cohort study conducted at Valiasr Hospital in Arak City, Iran, focused on patients with stroke registered in Arak University of Medical Sciences. 153 patients were examined. Data on demographics, stroke types, financial items, and National Institutes of Health Stroke Scale (NIHSS), Barthel, and modified Rankin Scale (mRS) scores were collected. NIHSS, mRS, and Barthel scales were used to assess economical findings of hospitalization and the first trimester after discharge in private and governmental health settings. Data were analyzed through SPSS software for statistical analysis.

Results: The study involved patients with a mean age of 69.53 [standard deviation (SD) = 13.4] years, who were hospitalized for about 4.97 days. Gender distribution was with women at 51% and men at
49%. After discharge, a significant majority (66%) received care exclusively from private settings, while 34% utilized both private and governmental services. In contrast, governmental settings showed no significant differences in costs related to NIHSS scores (P = 0.120). Similarly, Barthel scores indicated notable cost disparities in private settings at all stages
(P = 0.0001), while governmental settings exhibited no significant differences post-discharge (P = 0.777).

Conclusion: Our study reveals that patients primarily rely on private settings for post-discharge services, with costs largely borne by themselves. The financial burden of hospitalization is mostly covered by basic insurance.