COMPARING COST-EFFECTIVENESS OF A CENTRALIZED VERSUS DECENTRALIZED STROKE CARE SYSTEM- USING PATIENT-LEVEL DATA TO ESTIMATE SHORT- AND LONGTERM EFFECTS
Author(s)
Freriks RD1, Pizzo E2, Luijckx GJ3, Buskens E3, van der Zee D1, Mierau JO1, Lahr MM3
1University of Groningen, Groningen, The Netherlands, 2University College London, London, UK, 3University Medical Center Groningen, Groningen, The Netherlands
OBJECTIVES: Centralizing acute stroke treatment increases the chance of treatment and lowers costs from onset to treatment compared to care at community hospitals. It is unclear whether the centralized model is cost-effective in a real-world setting after treatment. METHODS: This study uses observational data from 780 patients in a decentralized system and 267 patients in a centralized system in the Northern Netherlands. Multiple observational datasets were linked to estimate actual healthcare costs and Quality-Adjusted Life Years (QALYs) up to 3 months. Secondary outcomes are lifetime QALYs and healthcare costs, using a probabilistic Markov model. Difference in outcome include 95% Confidence Intervals (CI). RESULTS: Mean healthcare costs up to 3 months are € 6,313 (CI, 5,507 – 7,118) for the centralized system compared to € 7,535 (CI, 7,060 – 8,010) for the decentralized system (P < 0.01). The mean QALYs at 3 months are 0.65 (CI, 0.63 – 0.67) for the decentralized system and 0.69 (CI, 0.65 – 0.73) for the centralized system (P < 0.10). Results remain stable after adjusting both parametrically and non-parametrically for age, gender, stroke severity on arrival, and referrer (P < 0.05). CONCLUSIONS: A centralized system for acute stroke care is cost-effective in a real-world setting. Centralizing acute stroke care significantly improves health of the patients by optimizing care efficiency – thereby substantially saving healthcare costs.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PHS54
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders