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Why invest in a national public health program for stroke? An example using Australian data to estimate the potential benefits and cost implications
journal contribution
posted on 2007-10-01, 00:00 authored by C Dominique, Rob CarterRob Carter, A Thrift, H DeweyObjectives: 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
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
History
Journal
Health policyVolume
83Issue
2-3Pagination
287 - 294Publisher
Elsevier Ireland Ltd.Location
Shannon, Republic of IrelandPublisher DOI
ISSN
0168-8510eISSN
1872-6054Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2007, Elsevier Ireland LtdUsage metrics
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