뇌졸중 환자의 의료 자원 이용과 비용 지출: 환자의 관점에서 = Utilization of Health Care Resources and Costs of Stroke Patients: Patients' Perspective

다국어 초록 (Multilingual Abstract)

Background: Policy-makers are required to know the current patterns of resource use and the costs of stroke. However, the scientific evidence, on which health policy-making can be based, is not sufficient. Our study aimed to investigate resource utilization and costs during the one year after stroke. Methods: Among patients with acute ischemic stroke (7 days from onset) who were admitted from July of 2001 to July of 2002, 223 were interviewed one year after the onset of stroke through a home visit by an experienced research nurse. Resource utilization and related costs were investigated. Results: The average length of stay was 25 days. The average first inpatients costs was ￦2,230,000. After discharge, the average outpatient visit was 22 days. The average expenditure per patient during the one year from onset of stroke was ￦5,235,000. The hospital charge was 59% of the total cost, the cost for hiring a care-giver was 14%, and the fee for the outpatient clinic was 13%. Thirty-nine percent (￦2,051,000) of the total expenditure was consumed in the first month, 12% was in the second, 8% was in the third, and around 5% monthly was after 3 months. Conclusions: Our study is the first one to investigate the resource utilization and the related costs in stroke patients in Korea. The results of this study should not be generalized to all Korean stroke patients, but this study may serve as a reference for inferring the real status in Korea and may be a starting point for further nationwide resource utilization and costs studies.

참고문헌 (Reference)

1 "an analysis of the direct cost and its clinical and social determinants" 1138-1141, 1997

2 "Utilization of health care resources after stroke.A population-based study of 258 hospitalized cases followed during the first year" 84 : 303-310, 1991

3 "Tissue plasminogen activator for acute ischemic stroke" 333 : 1581-1587, 1995

4 "The need for rehabilitation day care program service of stroke survivors family" 4 : 207-218, 2001

5 "The effects of patient and facility characteristics on the resource use by the elderly in long-term care services" 12 : 21-53, 2002

6 "The economic burden of stroke in the United Kingdom" 21 (21): 43-50, 2003

7 "Resource utilization and costs of stroke unit care integrated in a care continuum randomized study in elderly patients" 2569-2577, 2000

8 "Predictors of acute hospital costs for treatment of ischemic stroke in an academic center" 30 : 724-728, 1999

9 "Prediction of length of stay of first-ever ischemic stroke" 33 : 2670-2674, 2002

10 "Predicting outcomes of patients in Japan after first acute stroke using a simple model" 80 : 645-649, 2001

11 "Patient preferences for stroke outcomes" 25 : 1721-1725, 1994

12 "Methods of Economic Evaluation of Health Care Programmes" Oxford University Press 1997

13 "Management patterns and costs of acute ischemic stroke" 582-590, 2000

14 "Long-term prognosis after stroke:a community- based study in Japan" 11 : 8-15, 2001

15 "Inpatient costs,length of stay,and mortality for cerebrovascular events in community hospitals" 57 : 305-314, 2001

16 "Informal care for stroke surviviors results from the North East Melbournes Stroke Incidence Study" 1028-1033, 2002

17 "Hospital costs for stroke care in Singapore" 10 : 320-326, 2000

18 "Estimation of costs due to hospitalization for first-ever stroke patients in northern Taiwan" 261-267, 1999

19 "Costs of medical care after first-ever stroke in The Netherlands" 26 : 1830-1836, 1995

20 "Cost of stroke in the Netherlands from a societal perspective" 28 : 1375-1381, 1997

21 "Cost of stroke in Australia from a societal perspective results from the North East Melbourne Stroke Incidence Study" 2409-2416, 2001

22 "Cost of medical care after first-ever stroke in the Netherlands" 26 : 1830-1836, 1995

23 "A study of the effects of follow-up care for stroke survivors on primary caregivers quality of life" 3 : 169-180, 2000

24 "A population- based assessment of the impact and burden of caregiving for long-term stroke survivors" 26 : 843-849, 1995

25 "A natioanl study of the quantity and cost of informal caregiving for the elderly with stroke" 58 : 1754-1759, 2002

26 "2002년 사망원인통계결과" 통계청

27 "2002 건강보험심사평가통계연보" 2003 제25 :

28 "2001년 장래인구추계 결과. www.nso.go.kr" 통계청 2001년장래인구추계결과