Cost-effectiveness of multimodal CT for evaluating acute stroke

The neuroimaging workup for patients with suspected acute ischemic stroke has advanced significantly over the past few decades. Evaluation is no longer limited to noncontrast computed tomography (CT), but now frequently also includes vascular and perfusion imaging. Although acute stroke imaging has made significant progress with the development of multimodal approaches, there are still many unanswered questions regarding their appropriate use in daily patient care. It is important for all physicians taking care of stroke patients to be familiar with current multimodal CT and magnetic resonance imaging (MRI) techniques, including their strengths, limitations, and their role in guiding therapy.

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

Stroke ◽

10.1161/strokeaha.111.648238 ◽

2012 ◽

Vol 43 (6) ◽

pp. 1617-1623 ◽

Cited By ~ 19

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

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Multimodal CT-Assisted Thrombolysis in Patients With Acute Stroke

Stroke ◽

10.1161/strokeaha.110.605766 ◽

2011 ◽

Vol 42 (4) ◽

pp. 1129-1131 ◽

Cited By ~ 35

Author(s):

Víctor Obach ◽

Laura Oleaga ◽

Xabier Urra ◽

Juan Macho ◽

Sergio Amaro ◽

...

Keyword(s):

Acute Stroke ◽

Multimodal Ct

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Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge

Frontiers in Neurology ◽

10.3389/fneur.2021.710640 ◽

2021 ◽

Vol 12 ◽

Author(s):

Won Kee Chang ◽

Won-Seok Kim ◽

Min Kyun Sohn ◽

Sungju Jee ◽

Yong-Il Shin ◽

...

Keyword(s):

Cost Effectiveness ◽

Acute Stroke ◽

Study Protocol ◽

Transitional Care ◽

Controlled Trial ◽

Controlled Study ◽

Care Model ◽

Stroke Patients ◽

Randomized Controlled ◽

Early Supported Discharge

Introduction: Early supported discharge (ESD) is a transitional care model aimed at facilitating post-acute stroke patients' discharge to home. Previous studies have demonstrated that ESD provides equivalent patient and caregiver outcomes with superior cost-effectiveness compared to conventional rehabilitation (CR). This study intends to examine the feasibility of ESD in Korea.Methods and Analysis: This study is designed as a multicenter assessor-blinded, randomized controlled trial. Ninety post-acute stroke patients with mild to moderate disability (modified Rankin Scale 1–3) will be recruited from three university hospitals (30 patients per hospital) in Korea and allocated to either the ESD group or the CR group in a 1:1 ratio. Patients in the ESD group will receive individualized discharge planning and goal setting, a 4-week home-based rehabilitation program, and liaison service to community-based resources by a multidisciplinary team. Patients in the CR group will receive rehabilitation practices according to their current hospital policy.Outcomes: The primary outcome is the Korean version of the modified Barthel Index, and the primary endpoint was post-onset 3 months. Clinical outcomes, patient/caregiver reported outcomes, and socioeconomic outcomes will be measured at baseline, 1 month after discharge, 2 months after discharge, and 3 months after onset.Discussion: The efficacy and cost-effectiveness of ESD can vary according to the healthcare system and sociocultural aspects. To establish ESD as an alternative transitional care model for post-acute stroke patients in Korea, its feasibility needs to be examined in prior. This study will add evidence on the applicability of ESD in Korea.Ethical Considerations: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB number B-2012/654-308). The study protocol was registered at ClinicalTrials.gov (Identifier NCT04720820). Disseminations will include submission to peer-reviewed journals and presentations at conferences.

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The cost-effectiveness of the treatment of acute ischemic stroke with the use of thrombolytics in Brazil

10.5327/1516-3180.103 ◽

2021 ◽

Author(s):

Marcos Vinicius Teixeira Martins ◽

Veronica Perius de Brito ◽

Stefan Vilges de Oliveira

Keyword(s):

Ischemic Stroke ◽

Cost Effectiveness ◽

Length Of Stay ◽

Health System ◽

Acute Stroke ◽

Average Cost ◽

Intravenous Thrombolysis ◽

Private Institutions ◽

Public And Private ◽

The Cost

Introduction: Ischemic stroke causes major impacts on morbidity and mortality and intravenous thrombolysis is one of the main treatments. However, it has important temporal limitations, which justifies the study of other techniques. Objectives: Analyze the cost-effectiveness of treatments for acute stroke with the use of thrombolytics. Methodology: Epidemiological study with data from the Sistema de Informações Hospitalares do Ministério da Saúde, between 2015 and 2020 in Brazil. Results: There were 16488 hospitalizations, with an average cost of R$ 2687.70 (±379.40) and an average stay of 8.80 (±0.99) days. From 2015 to 2017, these values were, on average, 1829.67 (±917.46) hospitalizations, R$ 2715.50 (±190.86) and 9.80 (±1.62) days. Between 2018 and 2020, there are 3666.33 (±437.58), R$ 2773.22 (±108.86) and 8.13 (±0.29) days. The Northeast, Southeast and South of the country predominated with 36.09% (±0.73), 27.15% (±0.68) and 32.02% (±0.71) of occurrences, respectively. Average investments per hospitalization, for these regions, were R$ 2397.89 (±82.45), R$ 3178.29 (±38.89) and R$ 2806.16 (±56.33). As for the average stay, it was 7.30 (±1.11), 9.11 (±0.89) and 9.40 (±0.78) days. In public systems, 65.09% (±2.97) of registered treatments, the average cost was R$ 2815.09 (±122.34) and the average stay was 12.00 (±1.33) days. In private institutions these values were R$ 2747.14 (±98.13), and 8.90 (±0.92) days. Conclusions: There were increases in hospitalizations and costs with a reduction in length of stay. In addition, there were pronounced disparities between the regions of the country and public and private systems, which undermine equity in the health system.

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