Objectives: To analyze inpatient treatment costs and cost structure among elderly patients with ischemic stroke, and to investigate the association between stroke severity and both treatment costs and length of hospital stay.
Methods: A retrospective cross-sectional study with analytical components was conducted on 119 patients aged ≥60 years diagnosed with ischemic stroke and hospitalized at the National Geriatric Hospital. Clinical characteristics, stroke severity assessed by the National Institutes of Health Stroke Scale (NIHSS), length of stay (LOS), and inpatient hospital charges were collected from medical records and the hospital billing system. Descriptive statistics, the Kruskal–Wallis test, and multivariable generalized linear models (GLM) with a Gamma distribution and log link were used for data analysis.
Results: The mean age was 79.3 ± 9.2 years, with a nearly equal sex distribution. The mean NIHSS score was 15.1 ± 9.4. The mean LOS was 16.91 ± 14.42 days. Common complications included pneumonia (24.4%) and respiratory failure (20.2%). The median inpatient hospital charge was VND 29.46 million (IQR: 17.60–54.72 million), while the mean charge was VND 45.21 ± 52.76 million. Medications and intravenous fluids (32.11%) and bed charges (27.29%) accounted for the largest proportions of total hospital charges. Health insurance covered 61.13% of the total hospital charges. No statistically significant differences were observed in inpatient hospital charges or length of hospital stay across NIHSS severity groups (p > 0.05). In the multivariable GLM, stroke severity was not independently associated with inpatient hospital charges after adjustment for age, sex, and atrial fibrillation. Length of hospital stay was independently associated with higher hospital charges (adjusted cost ratio [aCR] = 1.05; 95% CI: 1.03–1.07; p < 0.001).
Conclusions: Inpatient hospital charges among older patients with acute ischemic stroke were highly variable, with medications, intravenous fluids, and bed charges accounting for the largest cost components. No statistically significant association was found between stroke severity measured by the NIHSS and inpatient hospital charges or length of hospital stay.