The One-Year Attributable Cost of Poststroke Aphasia

Abstract

BACKGROUND AND PURPOSE: Little is known about the contribution of aphasia to the cost of care for patients who experience stroke. METHODS: We retrospectively examined a cohort of South Carolina Medicare beneficiaries who experienced ischemic stroke in 2004 to determine the attributable cost of aphasia. Univariate analyses were used to compare demographic, comorbidity, and severity differences between individuals with poststroke aphasia and those without aphasia. Differences in payments by Medicare because of stroke were examined using a gamma-distributed generalized linear multivariate model. RESULTS: Three thousand, two hundred Medicare beneficiaries experienced ischemic stroke in South Carolina in 2004, and 398 beneficiaries had poststroke aphasia. Patients with aphasia experienced longer length of stays, greater morbidity, and greater mortality than did those without aphasia. In adjusted models that controlled for relevant covariates, the attributable 1-year cost of aphasia was estimated at $1703. CONCLUSIONS: Aphasia adds to the cost of stroke-related care, above the cost of stroke alone.