Neurointervention.  2022 Nov;17(3):152-160. 10.5469/neuroint.2022.00234.

National Trends in Medical Costs and Prognosis of Acute Ischemic Stroke Patients in Endovascular Thrombectomy Era: Analysis Using Medical Claim Data in Korea

• Jung WS
• Seo KD
• Suh SH

• KMID: 2535950
• DOI: http://doi.org/10.5469/neuroint.2022.00234

Abstract

Purpose
The purpose of this study was to evaluate trends in medical costs and prognosis in acute ischemic stroke (AIS) patients in Korea from 2008 to 2017 using medical claims data.
Materials and Methods
All data for the past decade was collected from a big data hub provided by the Health Insurance Review & Assessment Service. Using several Korean Standard Classification of Disease codes, we estimated the number of patients, the costs of medical insurance, and prognosis according to the treatment with or without endovascular thrombectomy (EVT) among in-patients with AIS.
Results
Since 2014, when EVT was covered by insurance, the number of patients who underwent EVT for AIS has increased significantly. Also, in the past decade, the medical costs following inpatient care for AIS with EVT have increased gradually, and the overall medical costs for the first year post-stroke have also increased. The prognosis of AIS patients with EVT was different according to the time of treatment. Annual trends for both mortality and cerebral hemorrhage after treatment of AIS with EVT have gradually decreased.
Conclusion
In this study, we found that both inpatient medical costs and 1-year cumulative medical costs have gradually increased, and the prognosis has gradually improved in patients receiving EVT treatment among AIS patients.

Keyword

Health insurance review & assessment; Acute ischemic stroke; Endovascular thrombectomy; Medical costs

Figure

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  Fig. 1. Change in inpatient cost per hospitalization for the tissue plasminogen activator (tPA)-only, endovascular treatment (EVT)-only, and total EVT groups. KRW, South Korean Won.

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  Fig. 2. Change in the average 1-year cumulative medical costs for the tissue plasminogen activator (tPA)-only, endovascular treatment (EVT)-only, and total EVT groups. KRW, South Korean Won.

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  Fig. 3. Time trends in 3-month, 1-year mortality, and cerebral hemorrhage for the tPA only group. tPA, tissue plasminogen activator.

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  Fig. 4. Time trends in 3-month, 1-year mortality, and cerebral hemorrhage for the total EVT group. EVT, endovascular treatment.

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  Fig. 5. Time trends in 3-month, 1-year mortality, and cerebral hemorrhage for the EVT only group. EVT, endovascular treatment.

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