Hospitalization Costs for Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis in the United States Are Substantially Higher Than Medicare Payments

BACKGROUND AND PURPOSE: It is important to know the costs for hospitalization for ischemic stroke patients treated with intravenous thrombolysis so that comparisons can be made with payments to hospitals. METHODS: Using the National Inpatient Sample, we evaluated hospitalization costs for patients treated with intravenous thrombolysis for acute ischemic stroke in the United States from 2001 to 2008. Cost data were correlated with demographics and clinical outcome. RESULTS: Intravenous thrombolysis for acute ischemic stroke was received by 63 472 patients; 24 094 patients were younger than age 65 years and 40 780 patients were 65 years or older. Median hospital costs in 2008 dollars were $14 102 (interquartile range, $9987-$20 819) for patients with good outcome, $18 856 (interquartile range, $13 145-$30 423) for patients with severe disability, and $19 129 (interquartile range, $11 966-$30 781) for patients with in-hospital mortality. Average 2008 Medicare payments were $10 098 for intravenous thrombolysis without complication and $13 835 for intravenous thrombolysis with major complication. CONCLUSIONS: Hospitalization costs for patients treated with intravenous thrombolysis are substantially higher than Medicare payments.