Ont Health Technol Assess Ser. 2020 Mar 6;20(7):1-70. eCollection 2020.
Stroke is a serious health issue in which an interruption in blood flow to any part of the brain damages brain cells. About 83% of people survive with substantial morbidity after their first stroke. We conducted a health technology assessment of continual long-term physiotherapy for people with a diagnosis of stroke, which included an evaluation of effectiveness, safety, cost-effectiveness, the budget impact of publicly funding continual long-term physiotherapy for people with a diagnosis of stroke, and patient preferences and values.
We performed a systematic literature search of the clinical evidence. We also performed a systematic literature search of the economic evidence. We did not conduct a primary economic evaluation because there was insufficient clinical evidence. We also analyzed the budget impact of publicly funding continual long-term physiotherapy after stroke in Ontario. To contextualize the potential value of continual long-term physiotherapy after stroke, we spoke with people who had been diagnosed with stroke, as well as their caregivers.
We did not find any published studies that met the specific clinical inclusion criteria. We did not identify any studies that compared the cost-effectiveness of continual long-term versus short-term physiotherapy after stroke. The budget impact of publicly funding continual long-term physiotherapy after stroke in Ontario over the next 5 years ranges from $445,000 in year 1 at an uptake rate of 8% to $888,000 in year 5 at an uptake rate of 16%. The people who had been diagnosed with stroke with whom we spoke reported that they had benefitted from continual long-term physiotherapy.
We did not identify studies that addressed the specific research question. Based on the clinical evidence review, we are unable to determine the benefits of continual long-term compared with short-term physiotherapy after stroke. The cost-effectiveness of continual long-term physiotherapy after stroke in Ontario is unknown. We estimate that publicly funding continual long-term physiotherapy after stroke in Ontario would result in additional costs of between $445,000 and $888,000 annually over the next 5 years. Patients and caregivers who we spoke with felt that patients who have experienced a stroke should be able to continue with physiotherapy.
中风是一个严重的健康问题，即流向大脑任何部位的血流中断会损害脑细胞。约83%的人在首次中风后虽存活下来但伴有严重的发病率。我们对诊断为中风的患者进行持续长期物理治疗的卫生技术评估，其中包括对有效性、安全性、成本效益、为诊断为中风的患者提供持续长期物理治疗的公共资金预算影响以及患者偏好和价值观的评估。
我们对临床证据进行了系统的文献检索。我们还对经济证据进行了系统的文献检索。由于临床证据不足，我们未进行初步经济评估。我们还分析了安大略省为中风后持续长期物理治疗提供公共资金的预算影响。为了将中风后持续长期物理治疗的潜在价值置于背景中，我们与被诊断为中风的患者及其护理人员进行了交谈。
我们未找到任何符合特定临床纳入标准的已发表研究。我们未确定任何比较中风后持续长期与短期物理治疗成本效益的研究。未来5年，安大略省为中风后持续长期物理治疗提供公共资金的预算影响范围从第1年以8%的接受率计算的44.5万美元到第5年以16%的接受率计算的88.8万美元。我们与之交谈的被诊断为中风的患者报告称，他们从持续长期物理治疗中受益。
我们未找到解决特定研究问题的研究。基于临床证据审查，我们无法确定中风后持续长期与短期物理治疗相比的益处。安大略省中风后持续长期物理治疗的成本效益未知。我们估计，未来5年安大略省为中风后持续长期物理治疗提供公共资金将导致每年额外成本在44.5万美元至88.8万美元之间。我们与之交谈的患者和护理人员认为，中风患者应该能够继续接受物理治疗。
