Scaletti Alessandro, Lauro Emiliana, Belfiore Patrizia, Zamparelli Bruno, Liguori Giorgio
Dipartimento di Studi Aziendali ed Economici, Università degli Studi di Napoli "Parthenope"
Dipartimento di Studi delle Istituzioni e dei Sistemi Territoriali, Università degli Studi di Napoli "Parthenope"
Ig Sanita Pubbl. 2014 Jan-Feb;70(1):57-79.
The Stroke Units (SU) delivers high quality care and treatment in patients affected by strokes. In Italy stroke is the second leading cause of death and the first of disability in adult people. There is significant evidence in literature indicating the better quality assistance SU provide in the treatment of neurological acute disease, with significant improvements in mortality and disability, when the therapeutic intervention (thrombolysis) is carried out within 3 hours after the onset of symptoms. Two are the aims of the present study: to evaluate the economic impact of both the start-up of Stroke Units in the Campania Region and the use of thrombolytic therapy for all treatable population. In the first case, the authors assume charges and costs on the national health service in absence of SU, rather than in the presence of these: the analysis compares the two alternatives to identify the most affordable one. Moreover, the authors try to estimate the potential savings achievable through the use of thrombolytic therapy: savings resulting from the difference between the number of cases treated in 2009 against the targeted population. By the results of the anticipate analysis, the global economic advantage for the Regional Banks is constituted by the sum of the savings hypothesized in two considered hypothesis. In the synthesis, the activation of SU and trombolytic treatment for all people whit eligibility criteria, may be considered health policy strategies extremely convenient for economic and social impact without causing high sacrifices for the Regional Banks.
卒中单元（SU）为中风患者提供高质量的护理和治疗。在意大利，中风是成年人死亡的第二大主要原因和致残的首要原因。文献中有大量证据表明，当在症状出现后3小时内进行治疗干预（溶栓）时，卒中单元在治疗急性神经疾病方面能提供质量更高的援助，死亡率和残疾率都有显著改善。本研究有两个目的：评估坎帕尼亚地区启动卒中单元以及对所有可治疗人群使用溶栓疗法的经济影响。在第一种情况下，作者假设在没有卒中单元而非有卒中单元的情况下，国家医疗服务体系的费用和成本：该分析比较这两种选择以确定最经济实惠的一种。此外，作者试图估算通过使用溶栓疗法可实现的潜在节省：节省的费用源于2009年治疗的病例数与目标人群之间的差异。根据预期分析的结果，地区银行的全球经济优势由两种假设情况下假设的节省费用之和构成。综合来看，为所有符合标准的人启动卒中单元和进行溶栓治疗，可被视为对经济和社会影响极为有利的卫生政策策略，且不会给地区银行带来巨大负担。
