Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance
Background Stroke is one of the largest single-condition sources of the global burden of non-communicable disease in terms of disability-adjusted life-years and monetary costs, directly as well as indirectly in terms of informal care and productivity loss. The objective was to assess the population...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-03-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/3/e043826.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846161866139631616 |
|---|---|
| author | Katharina S Sunnerhagen Mia von Euler Carl Willers Emma Westerlind Fredrik Borgström |
| author_facet | Katharina S Sunnerhagen Mia von Euler Carl Willers Emma Westerlind Fredrik Borgström |
| author_sort | Katharina S Sunnerhagen |
| collection | DOAJ |
| description | Background Stroke is one of the largest single-condition sources of the global burden of non-communicable disease in terms of disability-adjusted life-years and monetary costs, directly as well as indirectly in terms of informal care and productivity loss. The objective was to assess the population afflicted with ischaemic stroke in working age in the context of universal healthcare and social insurance; to estimate the levels of absence from work, the indirect costs related to that and to assess the associated patient characteristics.Methods This was a retrospective register-based study; all individuals registered with an ischaemic stroke during 2008–2011 in seven Swedish regions, covering the largest cities as well as more rural areas, were included. Individual-level data were used to compute net days of sick leave and disability pension, indirect costs due to productivity loss and to perform regression analysis on net absence from work to assess the associated factors. Costs related to productivity loss were estimated using the human capital approach.Results Women had significantly fewer net days of sick leave and disability pension than men after multivariable adjustment, and high-income groups had higher levels of sick leave than low-income groups. There were no significant differences for participants regarding educational level, region of birth or civil status. Indirect monetary costs amounted to €17 400 per stroke case during the first year, totalling approximately €169 million in Sweden.Conclusion The individual’s burden of stroke is heavy in terms of morbidity, and the related productivity loss for society is immense. Income-group differences point to a socioeconomic gradient in the utilisation of the Swedish social insurance. |
| format | Article |
| id | doaj-art-09fd89fa20ac40b8b37aaf738bc67047 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-09fd89fa20ac40b8b37aaf738bc670472024-11-20T23:10:08ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-043826Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insuranceKatharina S Sunnerhagen0Mia von Euler1Carl Willers2Emma Westerlind3Fredrik Borgström4Inst of Neuroscience and Physiology, Univ of Gothenburg, Gothenburg, Sweden3 Department of Neurology, Örebro University Hospital, School of Medicine, Örebro University, Örebro, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Goteborg, SwedenDepartment of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm, SwedenBackground Stroke is one of the largest single-condition sources of the global burden of non-communicable disease in terms of disability-adjusted life-years and monetary costs, directly as well as indirectly in terms of informal care and productivity loss. The objective was to assess the population afflicted with ischaemic stroke in working age in the context of universal healthcare and social insurance; to estimate the levels of absence from work, the indirect costs related to that and to assess the associated patient characteristics.Methods This was a retrospective register-based study; all individuals registered with an ischaemic stroke during 2008–2011 in seven Swedish regions, covering the largest cities as well as more rural areas, were included. Individual-level data were used to compute net days of sick leave and disability pension, indirect costs due to productivity loss and to perform regression analysis on net absence from work to assess the associated factors. Costs related to productivity loss were estimated using the human capital approach.Results Women had significantly fewer net days of sick leave and disability pension than men after multivariable adjustment, and high-income groups had higher levels of sick leave than low-income groups. There were no significant differences for participants regarding educational level, region of birth or civil status. Indirect monetary costs amounted to €17 400 per stroke case during the first year, totalling approximately €169 million in Sweden.Conclusion The individual’s burden of stroke is heavy in terms of morbidity, and the related productivity loss for society is immense. Income-group differences point to a socioeconomic gradient in the utilisation of the Swedish social insurance.https://bmjopen.bmj.com/content/11/3/e043826.full |
| spellingShingle | Katharina S Sunnerhagen Mia von Euler Carl Willers Emma Westerlind Fredrik Borgström Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance BMJ Open |
| title | Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance |
| title_full | Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance |
| title_fullStr | Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance |
| title_full_unstemmed | Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance |
| title_short | Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance |
| title_sort | health insurance utilisation after ischaemic stroke in sweden a retrospective cohort study in a system of universal healthcare and social insurance |
| url | https://bmjopen.bmj.com/content/11/3/e043826.full |
| work_keys_str_mv | AT katharinassunnerhagen healthinsuranceutilisationafterischaemicstrokeinswedenaretrospectivecohortstudyinasystemofuniversalhealthcareandsocialinsurance AT miavoneuler healthinsuranceutilisationafterischaemicstrokeinswedenaretrospectivecohortstudyinasystemofuniversalhealthcareandsocialinsurance AT carlwillers healthinsuranceutilisationafterischaemicstrokeinswedenaretrospectivecohortstudyinasystemofuniversalhealthcareandsocialinsurance AT emmawesterlind healthinsuranceutilisationafterischaemicstrokeinswedenaretrospectivecohortstudyinasystemofuniversalhealthcareandsocialinsurance AT fredrikborgstrom healthinsuranceutilisationafterischaemicstrokeinswedenaretrospectivecohortstudyinasystemofuniversalhealthcareandsocialinsurance |