Authors: Abdelsimar Tan Omar; Jose Danilo Diestro; Robert Joseph Sarmiento; Clare Angeli Enriquez; Lennie Lynn De Castillo; Beverly Ho; Kathleen Joy Khu; Jose Leonard Pascual (Manila, Philippines)
Determining the cost of hospitalization for acute stroke is important for the appropriate allocation of resources and the analysis of interventions for cost effectiveness. The objective of this study was to determine the total cost of hospitalization for acute stroke in a tertiary public hospital in the Philippines and identify the factors influencing cost.
The study was a retrospective review of medical and billing records of the hospital. Adult patients admitted for acute stroke between June 2017 to October 2017 were included in the analysis. After the mean cost of stroke was determined, multivariable logistic regression analysis was done to determine demographic and clinical characteristics that were predictive of stroke cost.
A total of 509 patient records were analyzed. The mean cost of stroke was 32,798.07 PHP (609.43 USD). Independent determinants of increased cost include stroke type (hemorrhagic stroke (p=0.001) and subarachnoid hemorrhage (p=0.001)), younger age (p=0.001), infection (p<0.001), length of hospital stay (p<0.001) and mechanical ventilation (p=0.001). The cost of hospitalization was higher than the fixed reimbursement rates provided by the National Health Insurance Program for all types of stroke except ischemic stroke.
The study provided current data on the cost of hospitalization for acute stroke in a public tertiary hospital in the Philippines. Stroke type, age, presence of infection, length of hospital stay, and need for mechanical ventilation were independent predictors of cost.