Table 5.

Articles about global cost related to stroke

First Author Year of publication Country	Objectives	Methods				Results
		Design and GRADE LEVEL[32]	Participants	Instruments	Calculated stroke costs
Alvarez-Sabin, 2013 (Spain) [44]	To find the cost of stroke in Spain	Epidemiological, observational, prospective, multicenter study 2 + GRADE	321 patients	Sociodemographic, clinical, and economic data	Direct costs Indirect costs	Total average cost per patient/year was €27,711. Direct healthcare costs €849 patient/year and non-healthcare costs to an average of €18,643patient/year. Productivity loss costs per patient/year were €276
Van Eeden, 2015 (Netherlands) [45]	Explore over 1 year poststroke the societal costs, changes in costs and quality of life (QoL) and the relation between costs and QoL	Epidemiological, observational, prospective, multicenter study 2 + GRADE	395 patients	Cost-of-illness (in Euros) and QoL (in utilities) of a disease	Direct costs Indirect costs	Indirect cost = €11,416 Direct cost = €18,068 Total societal costs for 1 year poststroke were €29 484
Xu, 2018 (UK), [46]	To estimate patient-level health and social care costs of stroke for all patients admitted to hospital with stroke in UK	Epidemiological, observational Retrospective Health economic simulation 2 + GRADE	111,846 patients	Health Care Costs Productivity Costs	Direct costs Indirect costs	The estimated stroke cost varied widely according to patient characteristics, ranging from €8149 to €49,922 at one year and €21,259 to €119,464 at five years
Benjamin. 2019 (EEUU) [4]	To estimate the cost of Cardio Vascular Diseases and risk factors	Statistical update 2 + GRADE	18,462 patients	Health interview surveys	Direct costs Indirect costs	Direct care €6673 /patient/year Post ictus Care €9412/patient/year
Luengo-Fernandez. 2020 (UK) [2]	To provide an estimate of the overall economic costs of stroke for all 28 countries of the EU	Population-based cost analysis 2 + GRADE	1,5 million patients 32 European countries	Population-based cost analysis	Direct costs Indirect costs	Health Care: €17,728 /patient/year Social Care: €3165/patient/year Productivity costs: €8336/ patient/year Informal care costs: €10,508/ patient/year Total costs: €39,736,66 /patient/year
Patel A, 2020 (UK) [47]	To estimate 2014/2015 annual cost from a societal perspective	Epidemiological retrospective study 2 + GRADE	331 patients	Annual mean cost per person and aggregate UK cost of stroke for individuals aged ≥ 40 Health and social costs	Direct costs Indirect costs	Mean cost of new-onset stroke is €61,665 (95% CI €57,109-€66,220) in the first year after stroke and €33,648 (€27,477-€39,819) in subsequent years
Rochmah TN, 2021 Indonesia [48]	To analyze the burden of stroke: analyzing the average length of hospitalization, and the magnitude of economic losses due to stroke	Systematic review 1 + GRADE	13 articles	Cost of illness studies that assess burden of stroke in primary and referral healthcare (hospital-based) Direct and indirect costs	Direct costs Indirect costs	The economic burden of stroke disease based on cost of illness method, which is approximately equal to € 1478- €265,613 (direct costs 86.2%, and indirect costs 13.8%)
Stefan Strilciuc, 2021 Romania[49]	To compile the results of existing studies on the economic burden of stroke,	Systematic review 1 + GRADE	forty-six articles published in twenty-three countries between 1994 and 2019	Across all cost perspectives	Overall costs	Costs in the per patient per year category varied from €103,578 in South Korea (for hemorrhagic stroke) to €610 in Singapore