High stroke-related costs predicted for Hispanic-Americans

Hispanics tend to have strokes at younger ages; three risk factors for stroke are common in this ethnic group.

Between now and the year 2050, ischemic strokes in Hispanic-Americans will cost an estimated $357 billion in health care dollars, according to a study presented at the American Stroke Association’s International Stroke Conference 2006. Devin Brown, MD, assistant professor of neurology at the University of Michigan in Ann Arbor, said these costs would include initial hospitalization, ongoing care and lost wages.

Brown and colleagues estimated the cost of treating ischemic stroke in Hispanics in 2005 was $3.2 billion. Hispanics — who recently became the largest minority group in the United States — will make up an estimated one-fourth of the population by 2050.

“Armed with this information, public health officials and researchers need to give high priority to preventing and treating strokes in this large group,” Brown said.

Inactivity, obesity and diabetes

Brown said Hispanics are twice as likely to develop ischemic stroke as non-Hispanic whites. “Three risk factors for stroke — inactivity, obesity and diabetes — tend to be more common in the Hispanic population,” Brown said.

The researchers projected costs using current Medicare reimbursement rates, either directly or as calculated in previous studies and presented in 2005 dollars. Projections from 2000 census data were used to estimate the population of Hispanics 45 years or older.

They then gauged the occurrence of stroke and the use of health care resources after stroke using data from two ongoing surveillance projects — the Brain Attack Surveillance in Corpus Christi (BASIC) project, which identifies strokes in a Texas community composed mostly of Mexican-Americans and non-Hispanic whites; and the Northern Manhattan Stroke Study (NOMASS), which surveys stroke incidence in an multiethnic urban community that is more than half Hispanics.

“We believe that estimates made with combined data from the two studies are more accurate and more reflective of the entire Hispanic community in the United States,” Brown said.

Treatment costs

Of the $357 billion stroke bill, 45% of that cost will be for treating new strokes, including ambulance services, initial hospitalization, rehabilitation services, medical equipment and visits to neurology clinics. Seventy-percent will be for the continuing care of patients who had strokes in a previous year, including medication, physician visits, nursing home costs and the value of informal caregiving.

“The value of informal caregiving — that care provided without charge by family and friends — was based on what a home health aide would receive for the same amount of time,” Brown said.

The three largest individual contributors to the estimated stroke bill for Hispanics were initial hospitalization ($86 billion), informal care ($60 billion) and lost earnings ($79 billion).

“A loss of earning ability hits Hispanics particularly hard because they tend to get strokes at younger ages and to need ongoing care,” Brown said. “Future research needs to address how best to target the Hispanic community in terms of stroke prevention, recognition of stroke symptoms and access to prompt treatment.”

For more information:

• Brown D, Boden-Albala B, Langa K, et al. The stroke economic burden in Hispanics: Projections for 2005-2050. #465. Presented at the American Stroke Association’s International Stroke Conference 2006. Feb. 16-18, 2006. Kissimmee, Fla.