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ORIGINAL RESEARCH|Articles in Press

The Excess Costs of Hospitalization for Acute Stroke in People With Communication Impairment: A Stroke123 Data Linkage Substudy

  • Emily L. Brogan
    Affiliations
    School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia

    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
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  • Joosup Kim
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia

    The Centre of Research Excellence in Stroke Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia

    Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
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  • Rohan S. Grimley
    Affiliations
    Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia

    The Centre of Research Excellence in Stroke Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia

    Griffith University, Queensland, Australia
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  • Sarah J. Wallace
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Queensland Aphasia Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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  • Caroline Baker
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Speech Pathology Department, Monash Health, Melbourne, Victoria, Australia
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  • Tharshanah Thayabaranathan
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia

    The Centre of Research Excellence in Stroke Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
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  • Nadine E. Andrew
    Affiliations
    The Centre of Research Excellence in Stroke Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia

    Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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  • Monique F. Kilkenny
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia

    The Centre of Research Excellence in Stroke Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
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  • Erin Godecke
    Affiliations
    School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia

    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
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  • Miranda L. Rose
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia
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  • Dominique A. Cadilhac
    Correspondence
    Corresponding author: Dominique A. Cadilhac, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia, Level 3 Hudson Institute Building, 27-31 Wright Street, Clayton VIC 3168, Australia.
    Affiliations
    Centre of Research Excellence in Aphasia Rehabilitation Recovery, La Trobe University, Bundoora, Victoria, Australia

    Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia

    The Centre of Research Excellence in Stroke Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia

    Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
    Search for articles by this author
Published:February 07, 2023DOI:https://doi.org/10.1016/j.apmr.2023.01.015

      Abstract

      Objective

      To describe the costs of hospital care for acute stroke for patients with aphasia or dysarthria.

      Design

      Observational study from the Stroke123 project.

      Setting

      Data from patients admitted with stroke (2009-2013) from 22 hospitals in Queensland participating in the Australian Stroke Clinical Registry (AuSCR) were linked to administrative datasets.

      Participants

      Communication impairments were identified using International Classification of Diseases, 10th Revision, Australian Modification codes. Overall, 1043 of 4195 (25%) patients were identified with aphasia (49% were women; median age 78 years; 83% with ischemic stroke), and 1005 (24%) with dysarthria (42% were women; median age 76 years; 85% with ischemic stroke).

      Interventions

      Not applicable.

      Main Outcome Measures

      Linked patient-level, hospital clinical costing related to the stroke, were adjusted to 2013/2014 Australian dollars (AU$, US$ conversion x 0.691) using recommended national price indices and multivariable regression analysis with clustering by hospital performed.

      Results

      Compared with patients without aphasia, the median hospital costs/patient were greater for those with aphasia for medical (aphasia AU$2273 vs AU$1727, P<.001), nursing (aphasia AU$3829 vs AU$2748, P<.001) and allied health services (aphasia AU$1138 vs AU$720, P<.001). Similarly, costs were greater for patients with dysarthria compared with those without dysarthria. Adjusted median total costs were AU$2882 greater for patients with aphasia compared with patients without aphasia (95% confidence interval, AU$1880-3884), and AU$843 greater for patients with dysarthria compared with those without dysarthria (95% confidence interval, AU$–301 to 1987).

      Conclusions

      People with communication impairment after stroke incur greater hospital costs, in particular for medical, allied health, and nursing resources.

      Keywords

      List of abbreviations:

      AuSCR (Australian Stroke Clinical Registry), ICD-10-AM (International Classification of Diseases 10th Revision, Australian Modification), TIA (transient ischemic attack)
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