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Economic evaluation of Australian stroke services: a prospective, multicenter study comparing dedicated stroke units with other care modalities

Moodie, Marjory, Cadilhac, Dominique, Pearce, Dora, Mihalopoulos, Cathrine, Carter, Robert, Davis, Stephen and Donnan, Geoffrey 2006, Economic evaluation of Australian stroke services: a prospective, multicenter study comparing dedicated stroke units with other care modalities, Stroke, vol. 37, no. 11, pp. 2790-2795.

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Title Economic evaluation of Australian stroke services: a prospective, multicenter study comparing dedicated stroke units with other care modalities
Author(s) Moodie, Marjory
Cadilhac, Dominique
Pearce, Dora
Mihalopoulos, Cathrine
Carter, Robert
Davis, Stephen
Donnan, Geoffrey
Journal name Stroke
Volume number 37
Issue number 11
Start page 2790
End page 2795
Publisher American Heart Association
Place of publication Dallas, Tex.
Publication date 2006-11
ISSN 0039-2499
1524-4628
Keyword(s) cost-effectiveness
stroke management
stroke units
Summary Background and Purpose: Level I evidence from randomized controlled trials demonstrates that the model of hospital care influences stroke outcomes; however, the economic evaluation of such is limited. An economic appraisal of 3 acute stroke care models was facilitated through the Stroke Care Outcomes: Providing Effective Services (SCOPES) study in Melbourne, Australia. The aim was to describe resource use up to 28 weeks poststroke for each model and examine the cost-effectiveness of stroke care units (SCUs). Methods: A prospective, multicenter, cohort study design was used. Costs and outcomes of stroke patients receiving 100% treatment in 1 of 3 inpatient care models (SCUs, mobile service, conventional care) were compared. Health-sector resource use up to 28 weeks was measured in 1999. Outcomes were thorough adherence to a suite of important clinical processes and the number of severe inpatient complications. Results: The sample comprised 395 participants (mean age 73 [SD 14], 77% first-ever strokes, males 53%). When compared with conventional care (n=84), costs for mobile service (n=209) were significantly higher (P=0.024), but borderline for SCU (n=102, P=0.08; $AUD12 251; $AUD15 903; $AUD15 383 respectively). This was primarily explained by the greater use of specialist medical services. The incremental cost-effectiveness of SCUs over conventional care was $AUD9867 per patient achieving thorough adherence to clinical processes and $AUD16 372 per patient with severe complications avoided, based on costs to 28 weeks. Conclusions: Although acute SCU costs are generally higher, they are more cost-effective than either mobile service or conventional care.
Language eng
Field of Research 140208 Health Economics
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2006, American Heart Association, Inc
Persistent URL http://hdl.handle.net/10536/DRO/DU:30004216

Document type: Journal Article
Collection: School of Health and Social Development
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Created: Mon, 07 Jul 2008, 09:15:13 EST