International Journal of Technology Assessment In Health Care, 6 (1990), 125-137. Copyright © 1990 Cambridge University Press. Printed in the U.S.A. DIRECT COSTS OF STROKE FOR A SWEDISH POPULATION Ulf Persson Raymunda Silverberg Bjorn Lindgren The Swedish Institute for Health Economics Bo Norrving Gun Jadback Barbro Johansson Lund University Hospital Britt-lnger Puranen Institute for Future Studies, Stockholm Abstract Direct costs were estimated for the treatment, rehabilitation, and nursing of 125 patients with first stroke in the Lund and Orup health districts (population of 200,191). Patients were followed from the onset of stroke in 1983 until October 31,1985. The data were used to calculate the present value of the ex- pected lifetime direct costs for an individual contracting his or her first stroke at various ages. For ex- ample, at the age of 72, these costs were estimated at SEK 283,000 for a man and SEK 561,000 for a woman. Hospital care was the major cost component (75% for males and 89% for females) at this age of onset. The results could be used to estimate the economic benefits of preventing new strokes, hence, forming part of a cost-effectiveness or cost-utility analysis. Together with prognoses of the ex- pected developments in the incidence of stroke, they could also serve as the basis of forecasts of future costs of the health care and social service sectors. In many Western countries, the treatment of stroke consumes a considerable portion of the total health expenditures, most of which occur in hospitals. In the United Kingdom, stroke patients were established to occupy 12% of all general medical bed days and 25% of the geriatric bed days or 6% of all hospital beds (3). Stroke is also reported to be one of the most common causes of hospital admission. At general hospitals in Great Britain, 8% and 11% of all male and female acute admissions, respec- tively, were due to stroke (1). Cerebrovascular diseases were estimated to cost the Na- tional Health Service (NHS) nearly £550 million in 1985 in England and Wales, i.e., 3.9% of the total NHS expenditure (4;5). For the 1975 incidence of stroke in the United States, total lifetime costs were cal- culated to be US $6.3 billion, of which $2.3 billion were direct costs (hospital and nursing This study was supported in part by grants from the Swedish Medical Research Council and the Swedish National Association against Heart and Chest Diseases.