Send to

Choose Destination
Int J Stroke. 2017 Jun;12(4):392-400. doi: 10.1177/1747493017691984. Epub 2017 Feb 6.

Modified Rankin scale as a determinant of direct medical costs after stroke.

Author information

1 Department of Public Health, Faculty of Medicine, UGent, Belgium.
2 Services in Health Economics, Brussels, Belgium.
3 Interuniversity Centre for Health Economics Research UGent, VUB, Belgium.
4 Cliniques Universitaires Saint Luc, Service de Neurologie, Brussels, Belgium.
5 Department of Neurology, Ghent University Hospital, Ghent, Belgium.
6 Neurology Department, Université catholique de Louvain (UcL), Yvoir, Belgium.
7 Centre Hospitalier Chrétien (CHC), Site Saint-Joseph, Liège, Belgium.
8 Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
9 Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
10 Department of Neurology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium.
11 Department of Neurology, Born Bunge Institute, University and University Hospital, Antwerp, Belgium.
12 Heilig Hart Ziekenhuis, Lier, Belgium.
13 CHU Ambroise Paré, Mons, Belgium.
14 Austin Health, Department of Neurology and Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.


Background Resource use in the acute and subacute phases after stroke depends on the degree of disability. Aims To determine if direct costs after stroke also vary by level of disability as measured using the modified Rankin scale at the chronic stage after stroke. Methods In a multicentre study, we collected acute and chronic in- and outpatient resource use in survivors of ischemic stroke stratified by levels of disability according to the modified Rankin Scale. Statistical inference on costs at each level of the modified Rankin Scale was estimated using a general linear model for the first three months, the first year, and any subsequent year after ischemic stroke. Results A total of 569 survivors of ischemic stroke with a mean age of 71.7 years were enrolled (41% female) from 10 academic and nonacademic centers. Costs varied substantially over time and with each modified Rankin Scale level. The total average costs in the first year were estimated $33,147 per patient, ranging from $9,114 for modified Rankin Scale 0 to $83,236 for modified Rankin Scale 5. In the second year, medical costs were on average $14,039, varying from $2,921 to $39,723 for patients with modified Rankin Scale 0-5. The level of disability based on the modified Rankin Scale was a major determinant of resource use, irrespective of age, gender, atrial fibrillation, and vascular risk factors. Conclusion Long-term resource use after stroke is high and is mainly driven by degree of disability as measured by the modified Rankin scale.


Stroke; cost analysis; costs; modified Rankin Scale

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center