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Development and application of model of resource utilization, costs, and outcomes for stroke (MORUCOS): an Australian economic model for stroke

journal contribution
posted on 01.10.2005, 00:00 authored by Cathy Mihalopoulos, D Cadilhac, Marj MoodieMarj Moodie, H Dewey, A Thrift, G Donnan, Rob CarterRob Carter
Objectives: To outline the development, structure, data assumptions, and application of an Australian economic model for stroke (Model of Resource Utilization, Costs, and Outcomes for Stroke [MORUCOS]).

Methods: The model has a linked spreadsheet format with four modules to describe the disease burden and treatment pathways, estimate prevalence-based and incidence-based costs, and derive life expectancy and quality of life consequences. The model uses patient-level, community-based, stroke cohort data and macro-level simulations. An interventions module allows options for change to be consistently evaluated by modifying aspects of the other modules. To date, model validation has included sensitivity testing, face validity, and peer review. Further validation of technical and predictive accuracy is needed. The generic pathway model was assessed by comparison with a stroke subtypes (ischemic, hemorrhagic, or undetermined) approach and used to determine the relative cost-effectiveness of four interventions.

Results: The generic pathway model produced lower costs compared with a subtypes version (total average first-year costs/case AUD$15,117 versus AUD$17,786, respectively). Optimal evidence-based uptake of anticoagulation therapy for primary and secondary stroke prevention and intravenous thrombolytic therapy within 3 hours of stroke were more cost-effective than current practice (base year, 1997).

Conclusions: MORUCOS is transparent and flexible in describing Australian stroke care and can effectively be used to systematically evaluate a range of different interventions. Adjusting results to account for stroke subtypes, as they influence cost estimates, could enhance the generic model.

History

Journal

International journal of technology assessment in health care

Volume

21

Issue

4

Pagination

499 - 505

Publisher

Cambridge University Press

Location

Cambridge, Eng.

ISSN

0266-4623

eISSN

1471-6348

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2005, Cambridge University Press