EE277 Cost of Stroke in Latin America: A Multicentric Time-Driven Activity-Based Costing Study

Abstract

Objectives Given the significant global health challenge posed by stroke, this study aims to measure stroke costs in Latin American countries by analyzing the precise costs of acute ischemic stroke and their regional variabilities using accurate microcosting techniques. Methods A comprehensive international multicenter study evaluated the direct costs of patients admitted with acute ischemic stroke from December 2021 to December 2022. Data were collected from stroke centers in Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, Peru, and Uruguay. Direct costs were assessed using a microcosting method. Factors considered included favorable outcomes (modified Rankin Scale (mRS) 0-2), clinical risk levels (age and stroke severity), and treatment interventions (medical treatment alone, intravenous thrombolysis, and mechanical thrombectomy). Purchasing power parity adjustments and international dollar conversions facilitated cross-country comparisons. Descriptive analyses were performed stratified by country and Generalized Estimating Equation models assessed the relationship between clinical variables and total cost per patient. Results The study included 1,106 patients. Among them, 74% received medical treatment alone, 18% received IVT, 4% underwent MT, and 3% received combined IVT and MT. Costs increased with patients clinical risk, outcomes, and treatment options. MT incurred costs 3.1 times higher than medical treatment alone, with an incremental cost of I$20,418 per patient (p < 0.001). Treating high-risk patients incurred substantial cost increases of I$7,512 compared to medium-risk patients (p < 0.0001) and I$7,866 compared to low-risk patients (p < 0.0001). Patients in the mRS 5-6 categories had costs twice as high as those in the mRS 0-2 categories. Conclusions The study reveals disparities in stroke costs across Latin America, offering a comprehensive understanding into the economic landscape and cost variations factors, particularly in under-researched regions. Continued investment in evidence-based research and value-based care models is essential to ensure equitable access and reduce disabilities and deaths.