Why invest in a national public health program for stroke? An example using Australian data to estimate the potential benefits and cost implications

Dominique, Cadilhac A., Carter, Robert C., Thrift, Amanda G. and Dewey, Helen M. 2007, Why invest in a national public health program for stroke? An example using Australian data to estimate the potential benefits and cost implications, Health policy, vol. 83, no. 2-3, pp. 287-294.

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Title Why invest in a national public health program for stroke? An example using Australian data to estimate the potential benefits and cost implications
Author(s) Dominique, Cadilhac A.
Carter, Robert C.
Thrift, Amanda G.
Dewey, Helen M.
Journal name Health policy
Volume number 83
Issue number 2-3
Start page 287
End page 294
Publisher Elsevier Ireland Ltd.
Place of publication Shannon, Republic of Ireland
Publication date 2007-10
ISSN 0168-8510
1872-6054
Keyword(s) stroke
health policy
economics
outcomes
Summary Objectives: Stroke is the world’s second leading cause of death in people aged over 60 years. Approximately 50,000 strokes occur annually in Australia with numbers predicted to increase by about one third over 10-years. Our objectives were to assess the economic implications of a public health program for stroke by: (1) predicting what potential health-gains and cost-offsets could be achieved; and (2) determining the net level of annual investment that would offer value-for-money.

Methods: Lifetime costs and outcomes were calculated for additional cases that would benefit if ‘current practice’ was feasibly improved, estimated for one indicative year using: (i) local epidemiological data, coverage rates and costs; and (ii) pooled effect sizes from systematic reviews.

Interventions: blood pressure lowering; warfarin for atrial fibrillation; increased access to stroke units; intravenous thrombolysis and aspirin for ischemic events; and carotid endarterectomy. Value-for-money threshold: AUD$30,000/DALY recovered.

Results: Improved, prevention and management could prevent about 27,000 (38%) strokes in 2015. In present terms (2004), about 85,000 DALYs and AUD$1.06 billion in lifetime cost-offsets could be recovered. The net level of annual warranted investment was AUD$3.63 billion.

Conclusions: Primary prevention, in particular blood pressure lowering, was most effective. A public health program for stroke
is warranted
Language eng
Field of Research 140208 Health Economics
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2007, Elsevier Ireland Ltd
Persistent URL http://hdl.handle.net/10536/DRO/DU:30007644

Document type: Journal Article
Collection: School of Health and Social Development
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