Long-term cost of stroke subtypes among Medicare beneficiaries

BACKGROUND AND PURPOSE: The economic impact of hemorrhagic stroke, including subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), has not been well characterized compared to the more prevalent ischemic stroke (IS). METHODS: Patients diagnosed with SAH, ICH or IS in 1997 were identified in a 5% national random sample of all Medicare beneficiaries. Medical care patterns and associated Medicare reimbursements were analyzed from one year prior to the index event through four years following that event. RESULTS: 11,430 patients were identified with SAH (n = 342), ICH (n = 1,957) or IS (n = 9,131). Average Medicare expenditures, from the initial event through four years, were USD 48,327 for SAH, USD 38,023 for ICH and USD 39,396 for IS. CONCLUSIONS: Long-term healthcare costs of SAH and ICH are substantial. With the expected increase in the elderly population over the coming decades, these results emphasize the need for effective preventive and acute medical care.