{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:33:49Z","timestamp":1791225229487,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Stroke is a major social and health problem posing heavy burden on national economies. We provided detailed financial data on the direct in-hospital cost of acute stroke care in Lebanon and evaluated its drivers. This was an observational, quantitative, prospective, multicenter, incidence-based, bottom-up cost-of-illness study. Medical and billing records of stroke patients admitted to 8 hospitals in Beirut over 1 year were analyzed. Direct medical costs were calculated, and cost drivers were assessed using a multivariable linear regression analysis. In total, 203 stroke patients were included (male: 58%; mean age: 68.8 \u00b1 12.9 years). The direct in-hospital cost for all cases was US$1 413 069 for 2626 days (US$538 per in-hospital day). The average in-hospital cost per stroke patient was US$6961 \u00b1 15 663. Hemorrhagic strokes were the most costly, transient ischemic attack being the least costly. Cost drivers were hospital length of stay, intensive care unit length of stay, type of stroke, stroke severity, modified Rankin Scale, third party payer, surgery, and infectious complications. Direct medical cost of acute stroke care represents high financial burden to Lebanese health system. Development of targeted public health policies and primary prevention activities need to take priority to minimize stroke admission in future and to contain this cost.<\/jats:p>","DOI":"10.1177\/0046958018792975","type":"journal-article","created":{"date-parts":[[2018,8,16]],"date-time":"2018-08-16T02:00:33Z","timestamp":1534384833000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Direct Medical Cost of Hospitalization for Acute Stroke in Lebanon: A Prospective Incidence-Based Multicenter Cost-of-Illness Study"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8131-1676","authenticated-orcid":false,"given":"Rachel R.","family":"Abdo","sequence":"first","affiliation":[{"name":"Lebanese University, Beirut, Lebanon"},{"name":"Paris-Est University, Creteil, France"},{"name":"Institut National de Sant\u00e9 Publique, d\u2019Epid\u00e9miologie Clinique et Toxicologie \u2013 Liban, Fanar, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halim M.","family":"Abboud","sequence":"additional","affiliation":[{"name":"Saint Joseph University, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale G.","family":"Salameh","sequence":"additional","affiliation":[{"name":"Lebanese University, Beirut, Lebanon"},{"name":"Institut National de Sant\u00e9 Publique, d\u2019Epid\u00e9miologie Clinique et Toxicologie \u2013 Liban, Fanar, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najo A.","family":"Jomaa","sequence":"additional","affiliation":[{"name":"Lebanese University, Beirut, Lebanon"},{"name":"Lebanese Geitaoui Hospital, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8850-6502","authenticated-orcid":false,"given":"Rana G.","family":"Rizk","sequence":"additional","affiliation":[{"name":"Institut National de Sant\u00e9 Publique, d\u2019Epid\u00e9miologie Clinique et Toxicologie \u2013 Liban, Fanar, Lebanon"},{"name":"Maastricht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan H.","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Henri Mondor Hospital AP-HP, Creteil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,8,15]]},"reference":[{"key":"bibr1-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"bibr2-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60694-7"},{"key":"bibr3-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-137"},{"key":"bibr4-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2010.09.014"},{"key":"bibr5-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e31829734f2"},{"key":"bibr6-0046958018792975","first-page":"117","volume":"5","author":"Lubitz J","year":"1984","journal-title":"Health Care Financ Rev"},{"key":"bibr7-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.192218"},{"key":"bibr8-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1097\/01.mrr.0000175269.59788.41"},{"key":"bibr9-0046958018792975","unstructured":"Bank of Beirut. Date unknown. www.bdl.gov.lb\/statistics\/table.php?name\u00bct5282usd. Accessed March 11, 2016."},{"key":"bibr10-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-016-0799-9."},{"key":"bibr11-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.11.2119"},{"key":"bibr12-0046958018792975","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"bibr13-0046958018792975","unstructured":"Oxford Stroke Classification. http:\/\/www.medquarterly.com\/mq88\/MQPDF\/MM\/OxfordStrokeClassification.pdf. 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