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Public Health Rep. 1977 May-Jun; 92(3): 272–279.
PMCID: PMC1432011

Financial expenditures for the care of cerebrovascular disease patients in an urban setting.


A study was undertaken to determine the magnitude of the charges and costs and the sources of reimbursements for the care of cerebrovascular disease (CVD) patients in an urban setting, Orleans Parish (County), Louisiana, in 1971. The study helps to put national data on the cost-burden of cerebrovascular disease into perspective at the community level. It is thought that such data may prove useful in planning and evaluation of intervention programs and more coordinated approaches to care. All hospitals, nursing homes, extended care facilities, and noninstitutional sources of care (home health and rehabilitation agencies) that were identified as providing services to CVD patients were invited to participate in the study, and a sample of such cases was selected from each participating facility. The billing records for these cases were then reviewed and analyzed to determine charges by category of service and sources of reimbursement. At government institutions, per diem rates were used to determine costs. Total charges for care of the CVD patients amounted to $6,070,000. Hospital care generated the major charge, amounting to $5,159,000 (85 percent of the total charges) during the study year. Nursing home care charges totaled $391,000 (6.5 percent), extended care services $373,000 (6.1 percent), and home health care and noninstitutional rehabilitation services $147,000 (2.4 percent). Analysis of the data according to type of service revealed that only a small percentage of the care dollar was spent for rehabilitation services. The greatest amounts were spent for room and board in institutional facilities and for drugs, diagnostic services, and miscellaneous other services in hospitals. Average expenditures per CVD case for rehabilitation services in institutions were highest in extended care facilities, being much lower in hospitals and negligible in nursing homes. Average expenditures for care by noninstitutional health service agencies were highest for home aide services, followed by nursing and rehabilitation services.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Clinical prevention of stroke. Stroke. 1972 Nov-Dec;3(6):806–825. [PubMed]
  • Carter AB. Hypotensive therapy in stroke survivors. Lancet. 1970 Mar 7;1(7645):485–489. [PubMed]
  • Freis ED. The Veterans Administration cooperative study on antihypertensive agents. Implications for stroke prevention. Stroke. 1974 Jan-Feb;5(1):76–77. [PubMed]
  • LEE RE, SELIGMANN AW, CLARK MA, ROUSSEAU PA. Freedom from cerebral vascular accidents during drug-induced blood pressure reduction in "benign" hypertensive disease. Am J Cardiol. 1963 Jun;11:738–742. [PubMed]
  • Beevers DG, Fairman MJ, Hamilton M, Harpur JE. Antihypertensive treatment and the course of established cerebral vascular disease. Lancet. 1973 Jun 23;1(7817):1407–1409. [PubMed]
  • Wylie CM. The value of early rehabilitation in stroke. Geriatrics. 1970 May;25(5):107–113. [PubMed]
  • Borhani NO. Stroke surveillance: the concept of stroke team in diagnosis, treatment and prevention. Stroke. 1974 Jan-Feb;5(1):78–80. [PubMed]
  • Geltner L. Comprehensive care of cerebrovascular accidents. Gerontol Clin (Basel) 1972;14(6):346–353. [PubMed]
  • Gibson CJ. Epidemiology and patterns of care of stroke patients. Arch Phys Med Rehabil. 1974 Sep;55(9):398–403. [PubMed]
  • Truscott BL, Kretschmann CM, Toole JF, Pajak TF. Early rehabilitative care in community hospitals: effect on quality of survivorship following a stroke. Stroke. 1974 Sep-Oct;5(5):623–629. [PubMed]
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