Survivors don't give a damn about cost, THEY WANT TO KNOW; DOES THIS GET ME RECOVERED? Are the funders that blitheringly stupid?
Stroke rehabilitation pathways during the first year: A cost-effectiveness analysis from a cohort of 460 individuals
Keywords
Abbreviations
Introduction
Stroke rehabilitation should be intensive, timely, and multidisciplinary, with coordinated transfers between settings, and effective interfacing with social and community care [1]. However, post-stroke care is considered disorganized and fragmented even in the best health systems [2], and many survivors express dissatisfaction [3]. There are no universally agreed best practices across European countries, where different health service structures and payment systems often lead to inconsistent care pathways, type, and quality of therapies [4,5].
Stroke defies worldwide health, social and economic policies, as a global leading cause of mortality and disability [6]. By 2047 there will be an additional 40,000 incident stroke cases (+3 %) and 2.58 million prevalent stroke cases (+ 27 %) [7], and the corresponding economic burden will increase [8]. Approximately 3 to 4 % of total health expenditures in Western countries are allocated to stroke [9]. In 2017, 32 European countries spent €60 billion on stroke care, of which 45 % was for health care, 8 % for social care, 47 % for direct and indirect productivity losses. Of the €27 billion spent on stroke healthcare, only 18 % was spent on rehabilitation [10].
Despite recovery from a stroke being an arduous journey that takes months or years [11] and covers a whole spectrum of care, including in-hospital, outpatient, and community-based rehabilitation [12], there are no published cost-effectiveness studies of integrated post-stroke pathways [13]. Our previous work showed 9 different rehabilitation pathways, that suggested heterogeneity, inefficiency, and inequalities, followed by a heterogeneous satisfaction level [14].
In the last years, there has been a call to design new care settings that ensure greater consistency and effectiveness to meet the targets set for 2030 by the Action Plan for Stroke [4]. The extent of the challenge, combined with limited healthcare budgets emphasizes the need for an evidence-based and cost-effective analysis that contributes to post-stroke decision-making [15], bridging the gap between clinical guidelines, organizational models, and the provision of care.
This study evaluated the cost-effectiveness of post-stroke rehabilitation pathways using high-quality individual participant-level data. It aimed to (i) determine the cost structure of each pathway and ii) determine the most cost-effective rehabilitation post-stroke care pathway from the perspective of the individuals with stroke and that of the healthcare service.
More at link.
No comments:
Post a Comment