Unseen Costs of Aneurysmal Subarachnoid Hemorrhage

A pilot prospective study provides data regarding the costs of aneurysmal subarachnoid hemorrhage (SAH). A devastating neurologic event, SAH affects 1 in 10,000 adults globally and has a mortality rate of more than 30%. Experiencing an SAH is financially straining for individuals and their caregivers because of invasive treatment, prolonged hospital stays, and involved recovery.

In the study, total indirect costs of SAH throughout the acute and subacute care period were estimated. 
Individuals who had experienced SAH and their self-reported primary caregivers were prospectively followed after the hemorrhagic event for up to 1 year. Information collected included demographics and any medical procedure. Total expenses were taken from follow-up interviews and hospital records and mean household income was estimated with zip code and US census data. A Wilcoxon signed-rank test was performed to determine whether there was a significant difference between incomes by zip code and reported income, which was not seen (P=.56). 

The most common indirect expenses reported by study participants (n=34) were transportation costs (mentioned by 58% of patients and caregivers), followed by food (41%). With the data suggesting a long hospital stay averaging 24.6 days these costs quickly multiplied. Additional indirect hospital costs reported were parking, ride shares, toiletries, clothes, home modifications, metro cards, hotels, and medications, which averaged $82/day. The average household income was $54,744 (+/- $21,084). Data suggests that the indirect hospitals costs imposed significant financial burden for families and patients. 

This study was presented at the International Stroke Conference 2020 in Los Angeles, CA Feb 19-21, 2020. The study is ongoing and has potential to uncover hidden costs of SAH and identify whether a small amount of additional financial support would be helpful for this patient population.