Stroke: Pediatric stroke costs U.S. $42M a year

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Stroke in children costs at least $42 million annually in the U.S., researchers reported in this month's edition of Stroke.

In a cost analysis of U.S. pediatric stroke, investigators reviewed data from U.S. children age 0 to 20, who used hospital inpatient services. They examined the Kid's Inpatient Database (KID 2003), which has 2,224 strokes recorded.

"This is just the upfront cost -- the initial stroke care of these children -- not the long-term care cost," said lead author Warren Lo, MD, associate professor of pediatrics and neurology at the Ohio State University and pediatric neurologist at Nationwide Children's Hospital, also located in Columbus, Ohio.

The authors noted that many other expenses will arise for those caring for a child recovering from a stroke, including transportation and lodging near a hospital with the capability to treat pediatric stroke; rehabilitation, if necessary; and missed time from work for caregivers.

"It's expensive for a kid to have a stroke," Lo said. "We must find more effective treatment -- earlier, better treatment -- that can reduce cost for kids staying in hospitals."

The investigators found that:

  • Acute treatment results in an average hospital stay of 8.3 days, costing almost $21,000;
  • Strokes characterized by subarachnoid hemorrhage resulted in an 11.2-day hospital stay and cost an average of more than $31,000;
  • The hospital stay for intracerebral hemorrhage averaged 9.6 days and costs an average of more than $24,000;
  • Ischemic stroke averaged a 6.6 day stay and $15,000 in costs.

Of the total, 22 percent were subarachnoid hemorrhage, 23 percent were intracerebral hemorrhage and 55 percent were ischemic stroke. In adults, roughly 13 percent of all U.S. strokes are the bleeding type, according to the American Heart Association (AHA)/American Stroke Association (ASA). However, in this study, the bleeding type accounted for 45 percent in children.

Furthermore, they reported that boys had more hemorrhages, while girls had more ischemic strokes. The strokes occurred most often in children ages 15 to 20 years old -- but the reasons for this were not clear.

The researchers also found that costs were higher at government/public hospitals and urban teaching hospitals. Costs were highest in the western U.S. and lowest in the South.

Of the cases, private insurance covered 55 percent of the children, Medicaid or Medicare government insurance programs covered 35 percent and self-pay or other coverage accounted for the remaining 10 percent. The study also found that for families with the higher incomes, childhood stroke costs were greater.

Researchers calculated actual pay in 2003 dollars for hospital services after discounts were applied and didn't include doctor fees that may have been billed separately. The authors said it was difficult to directly compare their results to studies of adults; however, the magnitude of the costs are similar.

The study was internally funded by the Research Institute at Nationwide Children's Hospital.