Healthcare (Sep 2023)
The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study
- Olga Siskou,
- Petros Galanis,
- Olympia Konstantakopoulou,
- Panagiotis Stafylas,
- Iliana Karagkouni,
- Evangelos Tsampalas,
- Dafni Garefou,
- Helen Alexopoulou,
- Anastasia Gamvroula,
- Maria Lypiridou,
- Ioannis Kalliontzakis,
- Anastasia Fragkoulaki,
- Aspasia Kouridaki,
- Argyro Tountopoulou,
- Ioanna Kouzi,
- Sofia Vassilopoulou,
- Efstathios Manios,
- Georgios Mavraganis,
- Anastasia Vemmou,
- Efstathia Karagkiozi,
- Christos Savopoulos,
- Gregorios Dimas,
- Athina Myrou,
- Haralampos Milionis,
- Georgios Siopis,
- Hara Evaggelou,
- Athanasios Protogerou,
- Stamatina Samara,
- Asteria Karapiperi,
- Nikolaos Kakaletsis,
- George Papastefanatos,
- Stefanos Papastefanatos,
- Panayota Sourtzi,
- George Ntaios,
- Konstantinos Vemmos,
- Eleni Korompoki,
- Daphne Kaitelidou
Affiliations
- Olga Siskou
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- Petros Galanis
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- Panagiotis Stafylas
- HealThink, 570 01 Thessaloniki, Greece
- Iliana Karagkouni
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- Evangelos Tsampalas
- Department of Neurology, Panarkadikon General Hospital, 221 00 Tripoli, Greece
- Dafni Garefou
- Department of Neurology, Panarkadikon General Hospital, 221 00 Tripoli, Greece
- Helen Alexopoulou
- Department of Neurology, Panarkadikon General Hospital, 221 00 Tripoli, Greece
- Anastasia Gamvroula
- Department of Neurology, Panarkadikon General Hospital, 221 00 Tripoli, Greece
- Maria Lypiridou
- Department of Neurology, Panarkadikon General Hospital, 221 00 Tripoli, Greece
- Ioannis Kalliontzakis
- Department of Neurology, General Hospital of Chania, 733 00 Creta, Greece
- Anastasia Fragkoulaki
- Department of Neurology, General Hospital of Chania, 733 00 Creta, Greece
- Aspasia Kouridaki
- Department of Neurology, General Hospital of Chania, 733 00 Creta, Greece
- Argyro Tountopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Ioanna Kouzi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Sofia Vassilopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Efstathios Manios
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Georgios Mavraganis
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Anastasia Vemmou
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Efstathia Karagkiozi
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 413 34 Larissa, Greece
- Christos Savopoulos
- 1st Medical Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, 546 36 Thessaloniki, Greece
- Gregorios Dimas
- 1st Medical Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, 546 36 Thessaloniki, Greece
- Athina Myrou
- 1st Medical Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, 546 36 Thessaloniki, Greece
- Haralampos Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, 455 00 Ioannina, Greece
- Georgios Siopis
- Department of Internal Medicine, School of Medicine, University of Ioannina, 455 00 Ioannina, Greece
- Hara Evaggelou
- Department of Internal Medicine, School of Medicine, University of Ioannina, 455 00 Ioannina, Greece
- Athanasios Protogerou
- Cardiovascular Prevention & Research Unit, Laiko General Hospital of Athens at the Medical School, National & Kapodistrian University of Athens, 115 27 Athens, Greece
- Stamatina Samara
- Cardiovascular Prevention & Research Unit, Laiko General Hospital of Athens at the Medical School, National & Kapodistrian University of Athens, 115 27 Athens, Greece
- Asteria Karapiperi
- Cardiovascular Prevention & Research Unit, Laiko General Hospital of Athens at the Medical School, National & Kapodistrian University of Athens, 115 27 Athens, Greece
- Nikolaos Kakaletsis
- Second Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokrateion General Hospital of Thessaloniki, 546 42 Thessaloniki, Greece
- George Papastefanatos
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- Stefanos Papastefanatos
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- Panayota Sourtzi
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- George Ntaios
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 413 34 Larissa, Greece
- Konstantinos Vemmos
- Hellenic Stroke Organization, 115 28 Athens, Greece
- Eleni Korompoki
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Department of Nursing National and Kapodistrian, University of Athens, 115 27 Athens, Greece
- DOI
- https://doi.org/10.3390/healthcare11182545
- Journal volume & issue
-
Vol. 11,
no. 18
p. 2545
Abstract
The aim of this study was to measure the one-year total cost of strokes and to investigate the value of stroke care, defined as cost per QALY. The study population included 892 patients with first-ever acute strokes, hemorrhagic strokes, and ischemic strokes, (ICD-10 codes: I61, I63, and I64) admitted within 48 h of symptoms onset to nine public hospitals located in six cities. We conducted a bottom-up cost analysis from the societal point of view. All cost components including direct medical costs, productivity losses due to morbidity and mortality, and informal care costs were considered. We used an annual time horizon, including all costs for 2021, irrespective of the time of disease onset. The average cost (direct and indirect) was extrapolated in order to estimate the national annual burden associated with stroke. We estimated the total cost of stroke in Greece at EUR 343.1 mil. a year in 2021, (EUR 10,722/patient or EUR 23,308 per QALY). Out of EUR 343.1 mil., 53.3% (EUR 182.9 mil.) consisted of direct healthcare costs, representing 1.1% of current health expenditure in 2021. Overall, productivity losses were calculated at EUR 160.2 mil. The mean productivity losses were estimated to be 116 work days with 55.1 days lost due to premature retirement and absenteeism from work, 18.5 days lost due to mortality, and 42.4 days lost due to informal caregiving by family members. This study highlights the burden of stroke and underlines the need for stakeholders and policymakers to re-organize stroke care and promote interventions that have been proven cost-effective.
Keywords