Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, 6060, Hall in Tirol, Austria.
Department of Health Sciences/Public Health, Dresden Medical School "Carl Gustav Carus", Technical University Dresden, Dresden, Germany.
Eur J Health Econ. 2019 Feb;20(1):107-134. doi: 10.1007/s10198-018-0984-0. Epub 2018 Jun 16.
Stroke is a leading cause for disability and morbidity associated with increased economic burden due to treatment and post-stroke care (PSC). The aim of our study is to provide information on resource consumption for PSC, to identify relevant cost drivers, and to discuss potential information gaps.
A systematic literature review on economic studies reporting PSC-associated data was performed in PubMed/MEDLINE, Scopus/Elsevier and Cochrane databases, Google Scholar and gray literature ranging from January 2000 to August 2016. Results for post-stroke interventions (treatment and care) were systematically extracted and summarized in evidence tables reporting study characteristics and economic outcomes. Economic results were converted to 2015 US Dollars, and the total cost of PSC per patient month (PM) was calculated.
We included 42 studies. Overall PSC costs (inpatient/outpatient) were highest in the USA ($4850/PM) and lowest in Australia ($752/PM). Studies assessing only outpatient care reported the highest cost in the United Kingdom ($883/PM), and the lowest in Malaysia ($192/PM). Fifteen different segments of specific services utilization were described, in which rehabilitation and nursing care were identified as the major contributors.
The highest PSC costs were observed in the USA, with rehabilitation services being the main cost driver. Due to diversity in reporting, it was not possible to conduct a detailed cost analysis addressing different segments of services. Further approaches should benefit from the advantages of administrative and claims data, focusing on inpatient/outpatient PSC cost and its predictors, assuring appropriate resource allocation.
中风是导致残疾和发病率上升的主要原因，其导致的经济负担增加是由于治疗和中风后护理（PSC）所致。我们的研究旨在提供有关 PSC 资源消耗的信息，确定相关成本驱动因素，并讨论潜在的信息差距。
在 PubMed/MEDLINE、Scopus/Elsevier 和 Cochrane 数据库、Google Scholar 和灰色文献中，对 2000 年 1 月至 2016 年 8 月期间报告 PSC 相关数据的经济研究进行了系统的文献综述。对中风后干预措施（治疗和护理）的结果进行了系统提取，并在报告研究特征和经济结果的证据表中进行了总结。将经济结果转换为 2015 年的美元，并计算每位患者每月（PM）的 PSC 总成本。
我们纳入了 42 项研究。总体而言，PSC 成本（住院/门诊）在美国最高（$4850/PM），在澳大利亚最低（$752/PM）。仅评估门诊护理的研究报告称，英国的成本最高（$883/PM），马来西亚的成本最低（$192/PM）。描述了 15 个不同的特定服务利用细分领域，其中康复和护理服务被确定为主要贡献者。
在美国观察到的 PSC 成本最高，康复服务是主要的成本驱动因素。由于报告的多样性，无法进行详细的成本分析，以解决不同服务细分领域的问题。进一步的方法应利用行政和索赔数据的优势，重点关注住院/门诊 PSC 成本及其预测因素，确保资源的合理分配。
