Patients' productivity losses and informal care costs related to ischemic stroke: a French population-based study

Eur J Neurol. 2021 Feb;28(2):548-557. doi: 10.1111/ene.14585. Epub 2020 Nov 6.

Abstract

Background and purpose: Large societal costs of stroke should not be ignored. We aimed to estimate patients' productivity losses and informal care costs during the first year after ischemic stroke.

Methods: A cross-sectional survey was performed within the STROKE69 regional population-based cohort study. At 1 year post-stroke, each patient and the corresponding main informal caregiver received questionnaires followed by a telephone interview if necessary. Time losses were valued using the human capital approach and proxy good method for patients with and without a professional activity, respectively.

Results: Among the 222 patients with ischemic stroke (58% men; mean age 68 years; and 86% with a modified Rankin Scale (mRS) score of <3 at 3 months), 54%, 32%, and 25% received informal, formal, and both cares, respectively. Among the 108 main informal caregivers, 63% were women, 74% lived with the patient, and 57% were retired or unemployed. The mean cost of productivity losses was estimated at €7589 ± €12 305 per patient in the first post-stroke year with 5.4%, 71.2%, and 23.4% of these being attributed to presenteeism, absenteeism, and leisure time, respectively. Informal care was given at an average of 25 h/week. The annual mean estimated total cost of informal care was €10 635 per caregiver.

Conclusions: Informal care and productivity losses of patients with ischemic stroke during the first post-stroke year represent a significant economic burden for society comparable to direct costs. These costs should be included in economic evaluations with the adoption of a societal perspective to avoid underestimating the societal stroke economic burden.

Keywords: caregivers; indirect costs; informal care; ischemic stroke; productivity losses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Ischemia* / therapy
  • Caregivers
  • Cohort Studies
  • Cost of Illness
  • Cross-Sectional Studies
  • Female
  • Health Care Costs
  • Humans
  • Ischemic Stroke*
  • Male
  • Patient Care
  • Stroke* / therapy