Evaluating the Cost-effectiveness analysis of rehabilitation methods for patients with stroke

Oh fuck, the stupidity of it all. 'COST' NOT RESULTS OR ANYTHING USEFUL TO SURVIVORS. That is where the stroke medical world is at, not solving stroke, concerned about cost. FUCK THEM, THEY ALL NEED TO BE FIRED!

 

Evaluating the Cost-effectiveness analysis of rehabilitation methods for       patients with stroke

 Farzaneh Miria , Nader Jahanmehrb , Reza Goudarzic a : School of management and medical education, Shahid Beheshti University of Medical Sciences, Tehran, Iran; b : Assistant Professor of Health Economics, Virtual school of Medical Education & Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Prevention of Cardiovascular Disease Research Center. Shahid Beheshti University of Medical Science, Tehran, Iran. c : Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Corresponding Author: Nader Jahanmehr, School of management and medical education, Shahid Beheshti University of Medical Sciences, Tehran, Iran 

Abstract 

Aims: 

This study evaluated and compared the cost-effectiveness of rehabilitation interventions in patients with stroke in the three alternatives of hospitals, units and homes due to the fact that one of the stroke management challenges is how to provide a rehabilitation service to these patients in Iran. 

Methods: 

This is a cost-effectiveness analysis from the perspective of a health system. A Markov model with a 20-year time horizon in 3-month cycles was used to analyze the costs and outcomes. Cost data were collected from the 210 patients undergoing rehabilitation in the hospital, home and unit. Utility data were extracted from previously published literature with the same setting. The cost-effectiveness analysis was conducted by calculating ICER using TreeAge Software. Basic and probabilistic sensitivity analyses were also conducted at the end . Results: The average cost of rehabilitation in home strategy ($ 2306) was less than hospital ($2955) and unit ($3485) strategies. Furthermore, the utility of home strategy (26.03) was 8 units higher than hospital utility (17.99) and 19 units higher than utility of the stroke unit (7.03). The Acer values of hospital, stroke unit and home groups were $11424, $33159 and $7233 per utility, respectively. According to the results, the home-based rehabilitation strategy is cost effective compared to hospital and unit rehabilitation strategy. The results of the probabilistic sensitivity analysis also showed that the ICER of home strategy is always cost-effective than the other strategies. Limitation: limitation of the present study was the reliance on utility values of other studies. 

 

Conclusion: 

Rehabilitation at home is the most cost-effective strategy for stroke patients. Given the high rates of this disease in Iran and the high cost of it, it is suggested that policy makers lay the groundwork for providing these services at home.