scholarly journals Does Spasticity Itself Raise the Cost of Stroke Care 4-Fold?

Stroke ◽  
2010 ◽  
Vol 41 (7) ◽  
Author(s):  
Bruce H. Dobkin
Keyword(s):  
Stroke Care ◽  
The Cost

scholarly journals The Cost-Effectiveness of Primary Stroke Centers for Acute Stroke Care

Stroke ◽  
2012 ◽  
Vol 43 (6) ◽  
pp. 1617-1623 ◽  
Author(s):  
Gregory F. Guzauskas ◽  
Denise M. Boudreau ◽  
Kathleen F. Villa ◽  
Steven R. Levine ◽  
David L. Veenstra
Keyword(s):  
Cost Effectiveness ◽  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care ◽  
The Cost

scholarly journals The Cost of Pediatric Stroke Care and Rehabilitation

Stroke ◽  
2008 ◽  
Vol 39 (1) ◽  
pp. 161-165 ◽  
Author(s):  
Warren Lo ◽  
Khaled Zamel ◽  
Kavita Ponnappa ◽  
Antoni Allen ◽  
Deena Chisolm ◽  
...  
Keyword(s):  
Stroke Care ◽  
Pediatric Stroke ◽  
The Cost

scholarly journals MO2 The Cost-Effectiveness of Primary Stroke Centers for Acute Stroke Care

2012 ◽  
Vol 15 (4) ◽  
pp. A8
Author(s):  
G.F. Guzauskas ◽  
D.M. Boudreau ◽  
K.F. Villa ◽  
S.R. Levine ◽  
D.L. Veenstra
Keyword(s):  
Cost Effectiveness ◽  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care ◽  
The Cost

scholarly journals “Strokenomics”: bending the cost curve in stroke care

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Stephan A. Munich ◽  
Kunal Vakharia ◽  
Matthew J. McPheeters ◽  
Michael K. Tso ◽  
Adnan H. Siddiqui ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Functional Outcomes ◽  
Mechanical Thrombectomy ◽  
Cost Savings ◽  
Cost Benefit ◽  
Stroke Care ◽  
Cost Curve ◽  
The Cost ◽  
Care Costs

OBJECTIVEThe mortality rates for stroke are decreasing, yet it remains a leading cause of disability and the principal neurological diagnosis in patients discharged to nursing homes. The societal and economic burdens of stroke are substantial, with the total annual health care costs of stroke expected to reach $240.7 billion by 2030. Mechanical thrombectomy has been shown to improve functional outcomes compared to medical therapy alone. Despite an incremental cost of $10,840 compared to medical therapy, the improvement in functional outcomes and decreased disability have contributed to the cost-effectiveness of the procedure. In this study the authors describe a physician-led device bundle purchase program implemented for the delivery of stroke care.METHODSThe authors retrospectively reviewed the clinical and radiographic data and device-associated charges of 45 consecutive patients in whom a virtual “stroke bundle” model was used to purchase mechanical thrombectomy devices.RESULTSUse of the stroke bundle to purchase mechanical thrombectomy devices resulted in an average savings per case of $2900.93. Compared to the traditional model of charging for devices à la carte, this represented an average savings of 25.2% per case. The total amount of savings for these initial 45 cases was $130,542.00. Thrombolysis in Cerebral Infarction scale grade 2b or 3 recanalization occurred in 38 patients (84.4%) using these devices.CONCLUSIONSPurchasing devices through a bundled model resulted in substantial cost savings while maintaining the therapeutic efficacy of the procedure, further pushing the already beneficial long-term cost-benefit curve in favor of thrombectomy.

Abstract 185: Residual Stroke Morbidity and Post-acute Care Cost: the IMS III Economic Data Cohort

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kit N Simpson ◽  
Annie N Simpson ◽  
Michael D Hill ◽  
Yuko Y Palesh ◽  
Edward C Jauch ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Cost Savings ◽  
Stroke Care ◽  
Office Visits ◽  
Economic Data ◽  
Post Discharge ◽  
Post Stroke ◽  
Initial Hospital ◽  
The Cost

Introduction: The IMS III trial included 1-year follow-up with prospectively collected data on resource use after stroke. While the trial showed no difference in 90-day clinical outcomes by treatment group, this cohort provides invaluable information on cost variations associated with post-stroke morbidity. We report the effect of residual stroke morbidity on cost of stroke care after discharge at 12 months post stroke. Methods: Among 470 subjects with moderate to severe stroke for whom economic data were collected (316 randomized to IV t-PA and endovascular therapy, 154 to IV t-PA alone), we estimated cumulative cost post discharge using cost weights derived from a 5% sample of US Medicare patients in 2012 with an admission for acute ischemic stroke with IV t-PA treatment. Cost weights included post-stroke rehabilitation hospital days, emergency care visits, hospital readmissions, medical office visits, rehabilitation therapy visits and nursing home days. Costs were summed at the level of the subject and estimated for the subset defined by NIH Stroke Scale Score (NIHSS) at day 5, and Modified Rankin Score (mRS) and Barthel Index (BI) at 3 months post stroke. Subjects who died during the initial hospital admission or who had no score at day 5 or at 3 months were not included in our analysis. Age-adjusted, log-transformed costs were compared. Results: There was a 6 fold difference in the cost of follow-up care by lowest and highest NIHSS at day 5 (p<.0001). Similarly large differences by outcome category were observed for both the mRS (p<.0001) groups and subjects defined by the BI (p<.0001) at 3 months (see Figure). Conclusion: Residual stroke morbidity has a large effect on the long-term cost of stroke care, with an effect size of over 600%. Interventions that improve the residual morbidity after stroke as early as day 5 may be expected to result in substantial post discharge cost savings.

scholarly journals Implementing the NHS England Long Term Plan for stroke: how should reperfusion services be configured? A modelling study

2021 ◽  
Author(s):  
Michael Allen ◽  
Kerry Pearn ◽  
Gary A. Ford ◽  
Phil White ◽  
Anthony Rudd ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Computer Modelling ◽  
Systems Of Care ◽  
Stroke Care ◽  
Net Benefit ◽  
Acute Stroke Care ◽  
Modest Improvement ◽  
Secondary Transfer ◽  
The Cost ◽  
The Impact

Objectives: To guide policy when planning reperfusion thrombolysis (IVT) and thrombectomy (MT) services for acute stroke in England, focussing on the choice between ‘mothership’ (direct conveyance to an MT centre) and ‘drip-and-ship' (secondary transfer for MT after local IVT) provision and the impact of bypassing local acute stroke centres.Methods: Computer modelling was used to estimate the likely outcomes from reperfusion therapies, along with admission numbers to units, based on expected times to IVT and MT.Results: Without pre-hospital selection for LAO, 94% of the population of England live in areas where the greatest clinical benefit accrues from direct conveyance to an IVT/MT centre. If this model was followed then net benefit from reperfusion is predicted to be increased from 31 to 34 additional disability-free outcomes / 1,000 admissions. However, this policy produces unsustainable admission numbers at these centres, and depletes all but 19 IVT-only units of all stroke admissions. Implementing a maximum permitted additional travel time to bypass an IVT-only unit, or using a pre-hospital test for LAO, both increase net benefit over the current drip-and-ship model, but produce a similar destabilising effect on acute systems of care. Use of IVT-only units manage admission numbers to IVT/MT centres.Conclusions: The mothership model reduces time to MT at the cost of increased time to IVT, but the benefit of faster MT is predicted to lead to a modest improvement in overall outcomes. Providing a sustainable national system of acute stroke care requires a hybrid of mothership and drip-and-ship provision.

scholarly journals Cost burden and cost-effective analysis of the nationwide implementation of the Quality in Acute Stroke Care protocol in Australia

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C M Marquina ◽  
Z A Ademi ◽  
E Z Zomer ◽  
R O A Ofori-Asenso ◽  
R T Tate ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Societal Perspective ◽  
Stroke Care ◽  
Decision Analytic Model ◽  
Stroke Severity ◽  
Acute Stroke Care ◽  
Stroke Incidence ◽  
Care Protocol ◽  
Life Years ◽  
The Cost

Abstract Background The Quality in Acute Stroke Care (QASC) protocol is a multidisciplinary approach to implement evidence-based treatment after acute stroke that reduces death and disability. Aim This study sought to evaluate the cost-effectiveness of implementing the QASC protocol across Australia, from a healthcare and a societal perspective. Methods A decision-analytic model was constructed to reflect one-year outcomes post-stroke, aligned with the stroke severity categories of the modified Rankin scale (mRS). Decision analysis compared outcomes following implementation of the QASC protocol versus no implementation. Population data were extracted from Australian databases and data inputs regarding stroke incidence, costs, and utilities were drawn from published sources. The analysis assumed a progressive uptake and efficacy of the QASC protocol over five years. Health benefits and costs were discounted by 5% annually. The cost of each year lived by an Australian, from a societal perspective, was based on the Australian Government's “value of statistical life year” (AUD 213,000). Results Over five years, the model predicted 263,722 strokes among the Australian population. The implementation of the QASC protocol was predicted to prevent 1,154 deaths and yield a gain of 876 years of life (0.003 per stroke), and 3,180 quality-adjusted life years (QALYs) (0.012 per stroke). There was an estimated net saving of AUD 65.2 million in healthcare costs (AUD 247 per stroke) and AUD 251.7 million in societal costs (AUD 955 per stroke). Conclusions Implementation of the QASC protocol in Australia represents both a dominant (cost-saving) strategy, from a healthcare and a societal perspective. FUNDunding Acknowledgement Type of funding sources: None. Decision tree PSA

scholarly journals Exploring Stroke Rehabilitation in Malaysia: Are Robots Better than Humans for Stroke Recuperation?

2021 ◽  
Vol 28 (4) ◽  
pp. 14-23
Author(s):  
Nik Nasihah Nik Ramli ◽  
Amhsavenii Asokan ◽  
Daniel Mayakrishnan ◽  
Hariharasudan Annamalai
Keyword(s):  
Stroke Rehabilitation ◽  
Stroke Care ◽  
Stroke Survivors ◽  
Language Therapy ◽  
Robot Assisted ◽  
Global Epidemic ◽  
The Past ◽  
Repetitive Movements ◽  
The Cost ◽  
Better Than

Ranked as the second leading cause of death and the primary factor to adult disability worldwide, stroke has become a global epidemic problem and burden. As a developing country, Malaysia still faces challenges in providing ideal rehabilitation services to individuals with physical disabilities including stroke survivors. Conventional post-stroke care is often delivered in a team- based approach and involves several disciplines, such as physical therapy, occupational therapy, speech and language therapy, depending on the nature and severity of the deficits. Robots are potential tools for stroke rehabilitation as they can enhance existing conventional therapy by delivering a precise and consistent therapy of highly repetitive movements. In addition, robot- assisted therapy could facilitate the effectiveness of unsupervised rehabilitation and thus, may reduce the cost and duration of therapist-assisted rehabilitation. Research on robot-assisted physiotherapy for stroke in Malaysia is slowly coming into the limelight in the past two decades. This review explores the effectiveness of robot-assisted physiotherapy particularly in improving motor functions of stroke survivors in Malaysia.

scholarly journals Trends in the Cost-Effectiveness of Stroke Care

2013 ◽  
Vol 16 (7) ◽  
pp. A520
Author(s):  
E. Urbina-Valdespino ◽  
Ö Saka ◽  
S. Crichton ◽  
A. Rudd ◽  
A. Mcguire ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Stroke Care ◽  
The Cost

Three-month modified Rankin Scale as a determinant of 5-year cumulative costs after ischemic stroke

Neurology ◽  
2020 ◽  
Vol 94 (9) ◽  
pp. e978-e991 ◽  
Author(s):  
Seong-Eun Kim ◽  
Heeyoung Lee ◽  
Jun Yup Kim ◽  
Keon-Joo Lee ◽  
Jihoon Kang ◽  
...  
Keyword(s):  
Research Collaboration ◽  
Stroke Care ◽  
Outcome Variable ◽  
Economic Evaluations ◽  
Modified Rankin Scale ◽  
Stroke Registry ◽  
The Mean ◽  
The Cost

ObjectiveStroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials.MethodsWe analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score.ResultsBetween January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0–5 years). Mean cumulative cost over 5 years was $117,576 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score (p < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke.ConclusionsWe show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.

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