Article Figures & Data
- Figure 1
Study population flowchart. CNSR, China National Stroke Registry; EMR, electronic medical record; TIA, transient ischaemic attack.
- Table 1
Geographic distribution of the chosen sites
Regions Sites from provincial capitals Sites from other cities East (Shanghai, Shandong Province, Zhejiang Province, Jiangsu Province) 4 1 West (Shaanxi Province, Sichuan Province, Chongqing Province, Yunnan Province) 2 1 South (Guangdong Province, Fujian Province, Guangxi Province) 2 1 North (Beijing, Tianjin, Liaoning Province, Jilin Province, Heilongjiang Province, Hebei Province) 4 1 Middle (Hubei Province, Hunan Province, Anhui Province, Henan Province, Jiangxi Province) 3 1 Total 15 5 - Table 2
Patient characteristics and univariate analysis results
Variable Total (N=520) Univariate analysis p values Direct medical cost Direct nonmedical cost Indirect cost Total cost Basic information Gender: male 362 (69.6%) 0.051 0.114 0.353 0.031 Age (years old) 61.64 (9.74) 0.046 0.822 p<0.001 0.068 Work status before stroke 0.178 0.387 p<0.001 p<0.001 Working (full-time, part-time, farm work) 170 (32.7%) Not working (retired, unemployed, stopped farm work) 350 (67.3%) Insurance: urban employee basic medical insurance 243 (46.7%) 0.73 0.231 p<0.001 0.003 Insurance: urban resident basic medical insurance 125 (24.0%) 0.766 0.746 0.014 0.069 Insurance: rural cooperation medical insurance 117 (22.5%) 0.038 0.239 p<0.001 p<0.001 Family monthly income per capita 0.002 0.037 p<0.001 p<0.001 <3000 CNY 77 (14.8%) 3000–8000 CNY 243 (46.7%) 8001–20 000 CNY 157 (30.2%) ＞20 000 CNY 43 (8.3%) Education level 0.814 0.519 p<0.001 0.033 College or above 51 (9.8%) High school 131 (25.2%) Junior school 180 (34.6%) Primary school 118 (22.7%) None 40 (7.7%) Hypertension 410 (78.8%) 0.486 0.857 0.053 0.287 Pathoglycemia 0.507 0.368 0.227 0.716 Pre-diabetes 14 (2.7%) Diabetes and classification 158 (30.4%) Lipid metabolism disorder 176 (33.8%) 0.7 0.22 0.858 0.812 Coronary heart disease 52 (10.0%) 0.195 0.669 0.166 0.499 Atrial fibrillation 31 (6.0%) 0.967 0.24 0.28 0.784 Treatment Time from onset to arrival (hours) 25.29 (30.96) 0.018 0.961 0.012 0.933 N-Miss 86 Admission NIHSS total score 3.92 (3.77) p<0.001 p<0.001 p<0.001 p<0.001 Intravenous thrombolysis: rt-PA intravenous thrombolytic 51 (9.8%) 0.011 0.774 0.01 0.459 Endovascular therapy: stent therapy 3 (0.6%) 0.012 0.864 0.614 0.189 Inpatient therapy: medicine 514 (98.8%) 0.449 0.934 0.979 0.771 Antiplatelet therapy 504 (96.9%) 0.26 0.852 0.84 0.43 Lipid-lowering drugs 509 (97.9%) 0.361 0.967 0.54 0.465 Antioxidant treatment 108 (20.8%) 0.743 0.524 p<0.001 0.002 Antihypertensive treatment 300 (57.7%) 0.417 0.835 0.757 0.442 Inpatient therapy: carotid artery stenting 3 (0.6%) 0.002 0.864 0.744 0.15 Inpatient therapy: decompressive craniectomy 0 (0.0%) / / / / Length of stay of index event (days) 13.80 (5.77) p<0.001 0.025 p<0.001 p<0.001 Discharge Discharge NIHSS total score 2.60 (2.90) p<0.001 0.026 p<0.001 p<0.001 Whereabouts after discharge 0.041 0.922 0.003 0.082 N-Miss 15 Home 482 (95.4%) Transferred to other hospitals (grade II) 5 (1.0%) Transferred to community hospital 2 (0.4%) Transferred to rehabilitation centre 12 (2.4%) Other 4 (0.8%) Discharge medication: antiplatelet agents 489 (94.0%) 0.009 0.359 0.559 0.061 Discharge medication: lipid-lowering drugs 493 (94.8%) 0.02 0.986 0.135 0.042 Discharge medication: antihypertensive therapy 317 (61.0%) 0.494 0.886 0.465 0.380 Discharge medication: antioxidant against lipid peroxidation 6 (1.2%) 0.674 0.831 0.174 0.207 Follow-up Living conditions during follow-up period 0.426 0.621 0.414 0.255 N-Miss 2 Living alone 25 (4.8%) Living with others 493 (95.2%) 3-month mRS score p<0.001 0.004 p<0.001 p<0.001 N-Miss 3 0–2 points 450 (87.0%) 3–5 points 67 (13.0%) 3-month EQ-5D utility 0.88 (0.17) p<0.001 0.055 p<0.001 p<0.001 N-Miss 2 12-month mRS score p<0.001 0.003 p<0.001 p<0.001 N-Miss 7 0–2 points 448 (87.3%) 3–5 points 65 (12.7%) 12-month EQ-5D utility 0.89 (0.18) p<0.001 0.341 0.041 p<0.001 N-Miss 6 EQ-5D, EuroQol 5 Dimension; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale.
- Table 3
Cost breakdowns
Cost type (N=520) Costs
Mean (SD), CNYSE 95% CI Total cost 57 567.48 (60036.44) 2632.77 52395.28, 62 739.68 Direct medical costs 26 612.67 (24373.40) 1068.84 24512.87, 28 712.46 Index event cost (hospitalisation cost) 18 143.79 (13381.40) 586.81 16990.97, 19 296.61 Follow-up cost 8468.88 (18667.60) 818.63 6860.64, 10 077.11 Rehabilitation 3942.55 (8594.02) 376.87 3202.16, 4682.93 Supportive care 1078.02 (3301.69) 144.79 793.58, 1362.46 Hospital care 3448.31 (15600.20) 684.11 2104.34, 4792.28 Direct nonmedical costs 2787.56 (25775.26) 1130.32 566.99, 5008.12 Index event cost 472.94 (1921.72) 84.27 307.38, 638.50 Food and accommodation (family members)* 32.89 (482.54) 21.16 0, 74.46 Homecare worker 428.10 (1859.68) 81.55 267.88, 588.31 Transportation 11.96 (24.19) 1.06 9.88, 14.05 Follow-up cost (homecare worker) 2314.62 (25381.53) 1113.05 127.97, 4501.26 Indirect costs 28 167.25 (44209.80) 1938.73 24358.53, 31 975.97 Index event cost 6741.62 (4359.28) 191.17 6366.07, 7117.18 Patient productivity loss 1767.05 (2887.73) 126.64 1518.27, 2015.84 Informal care 4974.57 (2648.44) 116.14 4746.40, 5202.74 Follow-up cost 21 425.63 (41653.21) 1826.61 17837.16, 25 014.09 Patient productivity loss 14 669.77 (32888.99) 1442.28 11836.35, 17 503.19 Informal care 6755.86 (20820.42) 913.04 4962.15, 8549.56 *Lower bound of 95% CI truncated to 0 due to costs being non-negative.
- Table 4
Multiple regression results
Variable exp(Beta) 95% CI P value Direct medical cost model Insurance: Rural cooperation medical insurance No / / / Yes 0.78 0.68, 0.90 <0.001 Insurance: Self-payment No / / / Yes 1.28 1.03, 1.60 0.029 Family monthly income per capita < 3000 CNY / / / 3000–8000 CNY 1.11 0.93, 1.31 0.3 8001–20 000 CNY 1.24 1.04, 1.49 0.017 ＞20 000 CNY 1.38 1.09, 1.77 0.009 Length of stay for index event 1.04 1.03, 1.05 <0.001 Admission NIHSS total score 1.04 1.02, 1.06 <0.001 Intravenous thrombolysis: rt-PA intravenous thrombolytic No / / / Yes 1.40 1.16, 1.70 <0.001 Inpatient therapy: carotid artery stenting No / / / Yes 3.07 1.60, 6.96 0.003 Whereabouts after discharge Home / / / Transferred to other hospitals (Grade II) 0.94 0.55, 1.75 0.8 Transferred to community hospital 0.69 0.32, 1.96 0.4 Transferred to rehabilitation centre 1.73 1.22, 2.55 0.004 Other 1.10 0.62, 2.20 0.8 Discharge medication: antiplatelet agents No / / / Yes 0.76 0.59, 0.96 0.027 3-month EQ-5D utility 0.64 0.39, 1.01 0.054 3-month mRS score 0–2 points / / / 3–5 points 0.81 0.63, 1.03 0.076 Indirect cost model Age (years old) 1.04 1.01, 1.08 0.021 Insurance: urban employee basic medical insurance No / / / Yes 0.45 0.23, 0.85 0.015 Insurance: urban resident basic medical insurance No / / / Yes 0.4 0.19, 0.84 0.017 Work status before stroke Working (full-time, part-time, farm work) / / / Not working (retired, unemployed, stopped farm work) 0.01 0.00, 0.02 <0.001 Admission NIHSS total score 1.1 1.01, 1.20 0.032 Length of stay for the index event 1.38 1.27, 1.53 <0.001 Intravenous thrombolysis: rt-PA intravenous thrombolytic No / / / Yes 0.41 0.15, 1.03 0.068 3-month EQ-5D utility 0.21 0.03, 1.79 0.2 3-month mRS score 0–2 points / / / 3–5 points 0.39 0.13, 1.17 0.1 Total cost model Education level College or above / / / High school 0.91 0.72, 1.16 0.5 Junior school 1.03 0.82, 1.29 0.8 Primary school 1.08 0.84, 1.37 0.5 None 1.33 0.97, 1.83 0.081 Work status before stroke Working (full-time, part-time, farm work) / / / Not working (retired, unemployed, stopped farm work) 0.46 0.40, 0.53 <0.001 Admission NIHSS total score 1.06 1.04, 1.09 <0.001 Length of stay for the index event 1.04 1.03, 1.05 <0.001 Inpatient therapy: antioxidant treatment Did not receive medicines / / / No 0.84 0.41, 1.52 0.6 Yes 0.74 0.35, 1.35 0.4 3-month EQ-5D utility 0.33 0.19, 0.57 <0.001 3-month mRS score 0–2 points / / / 3–5 points 0.81 0.62, 1.08 0.13 EQ-5D, EuroQol 5 Dimension; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale.
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Vol 9 Issue 4
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