Healthcare utilization and cost trajectories post-stroke: role of caregiver and stroke factors

Table 2 Trend estimates for post-stroke healthcare service utilization and costs

	Q1	Q2	Q3	Q4	p-value
Healthcare Service Used		IRR (95% CI)	IRR (95% CI)	IRR (95% CI)
Acute (Inpatient) service
Model 1	Ref	0.74 (0.54, 1.02)	0.65 (0.48, 0.88)	0.67 (0.47, 0.96)	0.020
Model 2	Ref	0.75 (0.54, 1.03)	0.66 (0.48, 0.89)	0.67 (0.47, 0.96)	0.020
Acute (ED) service
Model 1	Ref	0.90 (0.69, 1.18)	0.75 (0.58, 0.99)	0.82 (0.58, 1.17)	0.181
Model 2	Ref	0.91 (0.70, 1.19)	0.76 (0.58, 0.99)	0.82 (0.57, 1.17)	0.182
Outpatient (SOC) service
Model 1	Ref	1.00 (0.89, 1.13)	0.75 (0.67, 0.84)	0.74 (0.65, 0.85)	< 0.001
Model 2	Ref	0.98 (0.87, 1.11)	0.73 (0.65, 0.81)	0.71 (0.63, 0.81)	< 0.001
Outpatient (PC) service
Model 1	Ref	0.91 (0.79, 1.04)	0.89 (0.76, 1.04)	0.77 (0.67, 0.89)	0.001
Model 2	Ref	0.93 (0.81, 1.06)	0.93 (0.79, 1.09)	0.78 (0.67, 0.90)	0.002
Healthcare Costs		Exp(β) (95% CI)	Exp(β) (95% CI)	Exp(β) (95% CI)
Acute (Inpatient) costs
Model 1	Ref	0.65 (0.43, 0.98)	0.66 (0.40, 1.09)	0.50 (0.31, 0.79)	0.006
Model 2	Ref	0.52 (0.32, 0.83)	0.40 (0.23, 0.68)	0.33 (0.20, 0.54)	< 0.001
Acute (ED) costs
Model 1	Ref	0.86 (0.62, 1.19)	0.74 (0.53, 1.03)	0.95 (0.62, 1.45)	0.643
Model 2	Ref	0.81 (0.58, 1.13)	0.69 (0.49, 0.97)	0.94 (0.66, 1.34)	0.538
Outpatient (PC) costs
Model 1	Ref	1.28 (1.11, 1.48)	1.23 (1.06, 1.43)	1.30 (1.11, 1.53)	0.004
Model 2	Ref	1.33 (1.14, 1.54)	1.35 (1.15, 1.59)	1.36 (1.15, 1.62)	0.001

Model 1 has only quarter in the model; Model 2 has the additional covariates in the model (see below for details)
Service utilization model. Acute inpatient service: patient age, gender, ethnicity, caregiver identity, comorbid status; Acute ED service: patient age, gender, ethnicity, caregiver identity, comorbid status, religion; Outpatient SOC service: patient age, gender, ethnicity, stroke disability (measured on modified rankin scale), comorbid status; Outpatient PC service: patient age, gender, ethnicity, stroke type, stroke severity, ward class, comorbid status
Cost model. Acute inpatient cost: age, gender, ethnicity, caregiver identity, comorbid status, marital status, recurrent stroke; Acute ED cost: age, gender, ethnicity, caregiver identity, comorbid status; Outpatient PC cost: age, gender, ethnicity, stroke type, stroke severity, comorbid status
Abbreviations: Ref reference category, IRR incidence rate ratio, CI confidence interval, ED emergency department, SOC specialist outpatient clinic, PC primary care, Exp(β) exponentiated beta coefficient corresponds to the ratio of expected cost from Q2 to Q4 to the reference quarter respectively

ISSN: 1472-6963