Stroke ranks high for costs to healthcare systems. A study published online Oct. 10 in Neurology added the price of informal caregiving for elderly stroke survivors in the U.S. to the equation: almost $27 billion annually.

Heesoo Joo, PhD, and colleagues at the Centers for Disease Control and Prevention in Atlanta, used 2006 and 2008 survey data from the Health and Retirement Study to identify respondents 65 years and older with new onset stroke and estimate the number of hours relatives or others who are not paid for their assistance devote to these stroke survivors. They calculated costs using the median wage of a home health aide in 2008.

Based on a case-control study design with propensity score matching, they determined that in 2008 informal caregivers spent 16.1 hours a week caring for stroke survivors compared with 4.4 hours for elderly people without stroke. They determined that a weekly 8.5 hours was attributed to informal caregiving for stroke survivors.

In 2008, the cost of unpaid caregiving totaled $2,233 for an elderly person without stroke and $8,211 for one with stroke. They estimated the cost attributed to stroke care was $4,356 per patient. Applying that to the elderly stroke population in the U.S., the overall cost of informal caregiving reached $26.8 billion annually.

The $26.8 billion figure doesn’t include stroke patients who are younger than 65 or patients with recurrent stroke, Joo et al pointed out. Still, the results may provide evidence that will help in allocating resources aimed at reducing the burden of stroke.

“Public health decision-makers can consider this cost when they assess the total economic burden of stroke, set public health priorities, and allocate resources for stroke prevention,” they wrote. “The cost information presented here can also be incorporated into public health program evaluations, especially those that examine the cost-effectiveness or comparative effectiveness of stroke prevention and treatment programs.”