BACKGROUND AND PURPOSE: Evidence-based stroke care has been shown to improve patient outcomes and may reduce health system costs. Cost savings, however, are poorly quantified. This study assesses 4 aspects of stroke management (rapid assessment and treatment services, thrombolytic therapy, organized stroke units, and early home-supported discharge) and estimates the potential for cost avoidance in Canada if these services were provided in a comprehensive fashion. METHODS: Several independent data sources, including the Canadian Institute of Health Information Discharge Abstract Database, the 2008-2009 National Stroke Audit, and the Acute Cerebrovascular Syndrome Registry in the province of British Columbia, were used to assess the current status of stroke care in Canada. Evidence from the literature was used to estimate the effect of providing optimal stroke care on rates of acute care hospitalization, length of stay in hospital, discharge disposition (including death), changes in quality of life, and costs avoided. RESULTS: Comprehensive and optimal stroke care in Canada would decrease the number of annual hospital episodes by 1062 (3.3%), the number of acute care days by 166 000 (25.9%), and the number of residential care days by 573 000 (12.8%). The number of deaths in the hospital would be reduced by 1061 (14.9%). Total avoidance of costs was estimated at $682 million annually ($307.4 million in direct costs, $374.3 million in indirect costs). CONCLUSIONS: The costs of stroke care in Canada can be substantially reduced, at the same time as improving patient outcomes, with the greater use of known effective treatment modalities.
BACKGROUND AND PURPOSE: Evidence-based stroke care has been shown to improve patient outcomes and may reduce health system costs. Cost savings, however, are poorly quantified. This study assesses 4 aspects of stroke management (rapid assessment and treatment services, thrombolytic therapy, organized stroke units, and early home-supported discharge) and estimates the potential for cost avoidance in Canada if these services were provided in a comprehensive fashion. METHODS: Several independent data sources, including the Canadian Institute of Health Information Discharge Abstract Database, the 2008-2009 National Stroke Audit, and the Acute Cerebrovascular Syndrome Registry in the province of British Columbia, were used to assess the current status of stroke care in Canada. Evidence from the literature was used to estimate the effect of providing optimal stroke care on rates of acute care hospitalization, length of stay in hospital, discharge disposition (including death), changes in quality of life, and costs avoided. RESULTS: Comprehensive and optimal stroke care in Canada would decrease the number of annual hospital episodes by 1062 (3.3%), the number of acute care days by 166 000 (25.9%), and the number of residential care days by 573 000 (12.8%). The number of deaths in the hospital would be reduced by 1061 (14.9%). Total avoidance of costs was estimated at $682 million annually ($307.4 million in direct costs, $374.3 million in indirect costs). CONCLUSIONS: The costs of stroke care in Canada can be substantially reduced, at the same time as improving patient outcomes, with the greater use of known effective treatment modalities.
Authors: Hans Krueger; Sylvia Robinson; Trevor Hancock; Richard Birtwhistle; Jane A Buxton; Bonnie Henry; Jennifer Scarr; John J Spinelli Journal: BMC Health Serv Res Date: 2022-04-26 Impact factor: 2.908
Authors: Moira K Kapral; Jiming Fang; Frank L Silver; Ruth Hall; Melissa Stamplecoski; Christina O'Callaghan; Jack V Tu Journal: CMAJ Date: 2013-05-27 Impact factor: 8.262
Authors: Kit N Simpson; Annie N Simpson; Patrick D Mauldin; Michael D Hill; Sharon D Yeatts; Judith A Spilker; Lydia D Foster; Pooja Khatri; Renee Martin; Edward C Jauch; Dawn Kleindorfer; Yuko Y Palesch; Joseph P Broderick Journal: Stroke Date: 2014-05-13 Impact factor: 7.914
Authors: Lauren Jewett; Adil Harroud; Michael D Hill; Robert Côté; Theodore Wein; Eric E Smith; Gord Gubitz; Andrew M Demchuk; Demetrios J Sahlas; David J Gladstone; M Patrice Lindsay Journal: CMAJ Open Date: 2018-02-21
Authors: Lan Gao; Marj Moodie; Ben Freedman; Christina Lam; Hans Tu; Corey Swift; Sze-Ho Ma; Vincent C T Mok; Yi Sui; David Sharpe; Darshan Ghia; Jim Jannes; Stephen Davis; Xinfeng Liu; Bernard Yan Journal: J Am Heart Assoc Date: 2022-04-12 Impact factor: 6.106
Authors: Richard Fleet; Sylvain Bussières; Fatoumata Korika Tounkara; Stéphane Turcotte; France Légaré; Jeff Plant; Julien Poitras; Patrick M Archambault; Gilles Dupuis Journal: PLoS One Date: 2018-01-31 Impact factor: 3.240