Estimation of Life Expectancy, Expected Years of Life Lost, and Lifetime Cost Due to Intracerebral Haemorrhage in Korea

Although stroke mortality has been decreasing in the last three decades in Korea, the number of stroke survivors has increased and required long-term and costly care. This study aimed at estimating life expectancy (LE), the expected years of life lost (EYLL), and lifetime cost after the diagnosis of intracerebral haemorrhage (ICH) using a newly developed semi-parametric method for extrapolating long-term survival and cost analysis. Data on patients (n = 3,283) diagnosed with ICH (ICD-10, I61.x) in the National Health Database of Korea between 2005 and 2012 were extracted. The national life table of Korea was used to generate survival function for an age- and sex-matched reference population with Monte Carlo method. Lifetime survival of the patients with ICH were obtained through Kaplan-Meier method and extrapolated to 460 months with a semi-parametric method. The lifetime expenditures paid by the National Health Insurance Service (NHIS) and patients were estimated by multiplying average monthly expenditures by the survival probabilities and summing the values over lifetime after adjusted for annual discount rates. When the estimated LE after diagnosis of ICH was compared with that of the age- and sex-matched referents, the estimated EYLL was 64.76 months (about 5.5 years). Expected lifetime cost reimbursed by the NHIS would be about 40,000-47,400 USD accompanied with 10,800-12,900 USD out-of-pocket money from the patients and their families. The social impact is large, but further studies are needed to be integrated with quality of life and functional disability for a more detailed outcome assessment in the future.