Stroke is the third leading cause of mortality. Acute stroke centre is a specialised, multi-disciplinary and coordinated stroke care that improves stroke care by reducing patients with poor outcomes, death at discharge and functional dependence. This study aimed to assess the budget impact analysis of expanding acute stroke services/centres in the public healthcare setting in Malaysia.

The number of hospitalized stroke cases in the next five years is projected from the latest national stroke registry. The patients were segregated by severity, thrombolysis, and hospitalization duration by using information collected from two existing stroke centres. A mixed-costing method was used to estimate the treatment-related costs, including emergency department management, ward admission, medication, diagnostics, and the time-spent by healthcare personnel. There are currently three stroke centres (11%) among all MOH hospitals that treat stroke (N = 27). It was assumed that this number would increase by setting up three new centres annually starting from the second year, to a total of fifteen centres in five years. The cost of setting up a stroke centre including staff training is based on a latest local centre costs. The acute stroke centre was expected to reduce the hospital length-of-stay by 23%, according to a published meta-analysis. All costs were expressed in US dollars 2020 (1 USD = 4.05 MYR).

The baseline cost of acute stroke management in the public healthcare setting in Malaysia was estimated to be USD 74,207,780 in 2021. Based on the forecast, addition of centres starting from subsequent year, the total 5-year net budget impact was estimated to be a cost savings of USD 21,734,188.

The costs incurred to set up additional acute stroke centres and the continuous staff training is offset by lower healthcare resource utilization. This estimation will help to inform budget planning for stroke in the future in Malaysia.