Costs of medical care after first-ever stroke in the Netherlands

Background and Purpose: Stroke causes high morbidity and mortality. The aging of the population further increases tile demands on healthcare costs. Methods: We estimated the lifetime direct costs of care of first-ever stroke patients in the Netherlands in 1991 using epidemiological data from national and international studies. In addition, we examined the effect of an aging population on future healthcare costs. Results: The lifetime costs for 24 007 first-ever stroke patients are estimated to be 1870 million Dutch guilders (Dfl) (1 Dfl = 0.53 US dollar, 1991). Per-person costs are higher for women (83 000 Dfl) than for men (71 000 Dfl). The major cost component of first- year costs is hospital costs (45%), while nursing home costs dominate lifetime costs (50%). An increase of the elderly population older than 65 years of 27% between 1991 and 2010 might lead to a parallel increase of total costs of 30%, or 1.5% per year. Conclusions: Long-term care rather than acute care dominates the lifetime costs for stroke patients now and in the future.