BACKGROUND AND PURPOSE: Stroke places a significant burden on the economy in England and Wales with the overall societal costs estimated at pound7 billion per annum. There is evidence that both stroke units (SUs) and early supported discharge (ESD) are effective in treating patients with stroke. This study assesses the cost-effectiveness of the combination of these 2 strategies and compares it with the care provided in SU without ESD and in a general medical ward without ESD. The objective of this study was to model the long-term (10 years) cost-effectiveness of SU care followed by ESD. METHODS: The study design was cost-effectiveness modeling. The study took place in SUs in the coverage area of the South London Stroke Register, UK. The modeled population was incident ischemic stroke cases (N=844) observed between 2001 and 2006. SU care followed by ESD was compared with SU care without ESD and general medical ward care without ESD. Main outcome measures were health service and societal costs and cost per quality-adjusted life-year gained. RESULTS: Using the cost-effectiveness threshold of pound30000, as commonly used in the UK, SU care followed by ESD is the cost-effective strategy compared with the other 2 options. The incremental cost-effectiveness ratio of SU care followed by ESD is pound10661 compared with the general medical ward without ESD care and pound17721 compared with the SU without ESD. CONCLUSIONS: SU care followed by ESD is both an effective and a cost-effective strategy with the main gains in years of life saved.
BACKGROUND AND PURPOSE:Stroke places a significant burden on the economy in England and Wales with the overall societal costs estimated at pound7 billion per annum. There is evidence that both stroke units (SUs) and early supported discharge (ESD) are effective in treating patients with stroke. This study assesses the cost-effectiveness of the combination of these 2 strategies and compares it with the care provided in SU without ESD and in a general medical ward without ESD. The objective of this study was to model the long-term (10 years) cost-effectiveness of SU care followed by ESD. METHODS: The study design was cost-effectiveness modeling. The study took place in SUs in the coverage area of the South London Stroke Register, UK. The modeled population was incident ischemic stroke cases (N=844) observed between 2001 and 2006. SU care followed by ESD was compared with SU care without ESD and general medical ward care without ESD. Main outcome measures were health service and societal costs and cost per quality-adjusted life-year gained. RESULTS: Using the cost-effectiveness threshold of pound30000, as commonly used in the UK, SU care followed by ESD is the cost-effective strategy compared with the other 2 options. The incremental cost-effectiveness ratio of SU care followed by ESD is pound10661 compared with the general medical ward without ESD care and pound17721 compared with the SU without ESD. CONCLUSIONS:SU care followed by ESD is both an effective and a cost-effective strategy with the main gains in years of life saved.
Authors: Jeffrey J Fletcher; Vikas Kotagal; Aaron Mammoser; Mark Peterson; Lewis B Morgenstern; James F Burke Journal: Stroke Date: 2014-12-04 Impact factor: 7.914
Authors: Lisa Shaw; Nawaraj Bhattarai; Robin Cant; Avril Drummond; Gary A Ford; Anne Forster; Richard Francis; Katie Hills; Denise Howel; Anne Marie Laverty; Christopher McKevitt; Peter McMeekin; Christopher Price; Elaine Stamp; Eleanor Stevens; Luke Vale; Helen Rodgers Journal: Health Technol Assess Date: 2020-05 Impact factor: 4.014
Authors: Stefan A Baeten; N Job A van Exel; Maaike Dirks; Marc A Koopmanschap; Diederik Wj Dippel; Louis W Niessen Journal: Cost Eff Resour Alloc Date: 2010-11-17
Authors: Aaron Berkowitz; Nirali Vora; Morgan L Prust; Deanna Saylor; Stanley Zimba; Fred Stephen Sarfo; Gentle S Shrestha Journal: Stroke Date: 2022-01-20 Impact factor: 7.914
Authors: K Jack Ishak; Marilyn Stolar; Ming-yi Hu; Piedad Alvarez; Yamei Wang; Denis Getsios; Gregory C Williams Journal: BMC Health Serv Res Date: 2012-12-01 Impact factor: 2.655