Costs of pediatric stroke care in the United States: a systematic and contemporary review

Abstract

A substantial literature exists regarding cost-of-care outcomes in adult stroke, however less is known about pediatric stroke. The objective of this review of the literature was to examine studies of costs associated with pediatric stroke care. Six studies reporting data from individuals who experienced a pediatric stroke were included in the review. Cost data (charges and payments) were generally limited to one year and ranged from approximately US$15,000–140,000 depending upon stroke type. Pediatric stroke is linked to substantial costs but studies primarily emphasize the direct cost of care during the first year post-stroke onset. However, since many pediatric stroke survivors experience normal lifespans, they can also accumulate a significantly greater long term cost of care than strokes that occur in adulthood. Future studies are needed to examine long term direct costs, short and long term indirect costs and other economic outcomes in this population.

Keywords::

• costs
• economic
• outcome
• pediatric
• stroke

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The long-term direct and indirect financial burden of pediatric stroke may be greater than adult stroke.

• Cost-related data have yet to emerge beyond 5 years, although pediatric stroke survivors can live into adulthood.

• Cost-of-care data are critical to understanding service utilization patterns and which treatments and services are most cost–effective in achieving optimal outcomes.

• Current cost-of-care data for pediatric stroke include both reports of ‘charges’ and ‘payments’, thus limiting an interpretation of the overall cost perspective.

• Studies are needed to examine the long-term indirect cost of pediatric stroke or the cost of care outside of the primary hospital where care was received.

• Studies are needed to examine the ‘indirect costs’ of pediatric stroke to the stroke survivor and their families.