Background
Compared with the direct costs, the indirect costs of stroke may be larger contributors
to the socioeconomic burden of stroke, and the need to better understand the indirect
costs of stroke is well established. We investigated the indirect costs of stroke
according to a novel outcome, the use of stroke-related income supplements, in a Finnish
cohort of working-aged patients.
Methods
Consecutive patients (n = 230) who experienced a first-ever ischemic stroke were recruited.
Demographic, clinical, and cognitive function data (which were measured using clinical
neuropsychological assessments) were collected at baseline and at 6-month and 2-year
follow-ups. Data on the use of income supplements within the first 3 years of the
stroke were retrieved from national insurance registry files and used to construct
survival models.
Results
Stroke patients used a mean of 11 months of stroke-related income supplements; this
use was associated with atrial fibrillation, cognitive impairment, prestroke income
supplement use, higher National Institutes of Health Stroke Scale scores, lower Barthel
Index scores, and increased lesion sizes. In multivariate survival models, atrial
fibrillation and cognitive impairment were the factors most strongly associated with
the use of stroke-related income supplements.
Conclusions
Using stroke-related income supplement data to quantify poststroke productivity losses
allowed a working-aged cohort to be investigated without inclusion restrictions based
on occupational status or other factors; the use of these data as an outcome emphasized
the well-known detrimental effects of atrial fibrillation and cognitive impairment
on stroke outcome. The results support stroke-related income supplement use as a complementary
outcome for understanding stroke-related productivity losses.
Key Words
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Article info
Publication history
Published online: June 18, 2015
Accepted:
March 8,
2015
Received in revised form:
February 25,
2015
Received:
October 9,
2014
Footnotes
This study was funded by The Finnish Social Insurance Institution's (KELA's) Research Department and the Finnish Cultural Foundation's Lapland Regional Fund.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.049
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
