From the Guidelines
The long-term indirect costs of stroke are substantial, estimated at $15,000-$30,000 per patient annually, with lifetime costs potentially exceeding $100,000 per patient, as reported in the most recent study 1. The estimation of long-term indirect costs in stroke patients is a complex issue, involving lost productivity and the cost of informal caregivers.
- Lost productivity accounts for approximately 58% of these indirect costs, as many stroke survivors cannot return to work or must reduce their working hours.
- The average productivity loss ranges from $10,000-$20,000 per year per patient, depending on age, occupation, and stroke severity, as noted in 1.
- Informal caregiving costs, often overlooked in economic analyses, contribute significantly to the financial burden, with family members providing an average of 20-40 hours of unpaid care weekly, valued at $12,000-$25,000 annually, as discussed in 1. These costs persist for years after the initial stroke event, with the highest burden occurring in the first year but continuing for 5-10 years afterward.
- Stroke severity directly correlates with higher indirect costs, with severe strokes resulting in 2-3 times higher informal care needs compared to mild strokes.
- Age also impacts these costs, with younger stroke survivors generating higher lifetime productivity losses despite potentially better recovery, as mentioned in 1. Comprehensive rehabilitation programs, though initially expensive, can reduce long-term indirect costs by improving functional outcomes and reducing dependency on caregivers, potentially saving $5,000-$10,000 annually in indirect costs per patient, as suggested by the most recent evidence 1.
From the Research
Estimation of Long-Term Indirect Costs in Stroke Patients
- The indirect costs of stroke, including lost productivity and the cost of informal caregivers, have been studied in various research papers 2, 3, 4, 5.
- A literature review of indirect costs associated with stroke found that indirect costs account for a significant portion of the economic burden of stroke, with a wide range of estimates internationally (from 3% to 71%) 2.
- A study estimating the lifetime cost of stroke in the United States found that indirect costs accounted for 58.0% of lifetime costs, with an average lifetime cost per person of $103,576 across all stroke sub-types 3.
- An international review of the costs of stroke found that the total per patient long-term cost of care varied significantly, with estimates ranging from $18,538 to $228,038 4.
- A contemporary analysis of the costs of stroke in the United States found that indirect costs accounted for 66% of the total aggregate expenditure, with a total of $103.5 billion incurred in 2016 US-dollar values 5.
- The cost of informal caregivers and lost productivity due to stroke can be substantial, with estimates of $38.1 billion in indirect costs from under-employment and $30.4 billion from premature mortality 5.
Factors Influencing Indirect Costs
- The perspective employed, cost variables considered, and exclusion of comorbidities can all impact estimates of indirect costs 4.
- The age of the patient can also influence indirect costs, with younger patients potentially experiencing greater losses in productivity due to stroke 5.
- The type of stroke (e.g. ischemic, hemorrhagic) can also impact indirect costs, with different types of stroke having different associated costs and outcomes 3, 5.
Methods for Estimating Indirect Costs
- Various methods have been used to estimate indirect costs, including econometric models, generalized linear models, and negative binomial regression models 5.
- The use of nationally representative data, such as the Medical Expenditure Panel Survey, can provide valuable insights into the indirect costs of stroke 5.
- The estimation of loss of productivity due to premature death can be computed using the Present-Value of one life and annual number of deaths from National Vital Statistics 5.