Annual Costs of Stroke in U.S. Children at Least $42 million

July 9, 2009

Stroke in children costs at least $42 million annually in the United States, researchers report in Stroke: Journal of the American Heart Association.

In the first cost analysis of pediatric stroke in the United States, researchers reviewed data from U.S. children age 0 to 20 who used hospital inpatient services. The database, the Kids Inpatient Database (KID 2003), recorded 2,224 strokes. 

This is just the upfront cost the initial stroke care of these children not the long-term care cost, said lead author Warren Lo, M.D., pediatric neurologist at Nationwide Childrens Hospital in Columbus, Ohio, and associate professor of pediatrics and neurology at The Ohio State University College of Medicine.

Many other expenses will arise for those caring for a child recovering from a stroke, including transportation and lodging near a hospital with the capability to treat pediatric stroke; rehabilitation, if necessary; and missed time from work for caregivers.

Its expensive for a kid to have a stroke, Lo said. We must find more effective treatment earlier, better treatment that can reduce cost for kids staying in hospitals.

The study found:
 Acute treatment results in an average hospital stay of 8.3 days, costing almost $21,000.
 Strokes characterized by bleeding between the brain and skull (subarachnoid hemorrhage) resulted in an 11.2-day hospital stay and cost a average of more than $31,000.
 The hospital stay for bleeding inside the brain (intracerebral hemorrhage) averaged 9.6 days and cost an average of more than $24,000.
 Ischemic stroke (caused by a blockage in a blood vessel in or leading to the brain) averaged a 6.6 day stay and $15,000 in costs.

Costs were higher at government/public hospitals and urban teaching hospitals. Also, costs were highest in the western United States and lowest in the South, researchers said.

Of the total, 22 percent were subarachnoid hemorrhage, 23 percent were intracerebral hemorrhage and 55 were ischemic stroke.

In adults, roughly 13 percent of all U.S. strokes are the bleeding type, according to the American Heart Association/American Stroke Association. However, in this study, the bleeding type accounted for almost 45 percent in children.

Of the cases, private insurance covered 55 percent of the children, Medicaid or Medicare government insurance programs covered 35 percent and self-pay or other coverage accounted for the remaining 10 percent. The study also found that for families with the higher incomes, childhood stroke costs were greater.

Furthermore, boys had more hemorrhages, while girls had more ischemic strokes. The strokes occurred most often in children ages 15- to 20-years-old but the reasons for this were not clear.

Researchers calculated actual pay in 2003 dollars for hospital services after discounts were applied and didnt include doctor fees that may have been billed separately. Researchers said it was difficult to directly compare to studies of adults; however, the magnitude of the costs are similar.

Co-authors are: Elizabeth Perkins, an undergraduate student; Julie Stephens, M.S.; and Huiyun Xiang, M.D., Ph.D. Individual author disclosures can be found on the manuscript.

The study was internally funded by The Research Institute at Nationwide Childrens Hospital.

Editors note:  Get more information from the American Stroke Association http://www.strokeassociation.org/presenter.jhtml?identifier=3030392.

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report ‘s 2018-19 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.4 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.