Abreu Pedro, Correia Manuel, Azevedo Elsa, Sousa-Pinto Bernardo, Magalhães Rui
Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal.
Department of Clinical Neurosciences and Mental Health, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Cost Eff Resour Alloc. 2024 Mar 12;22(1):22. doi: 10.1186/s12962-024-00518-3.
Stroke readmissions are considered a marker of health quality and may pose a burden to healthcare systems. However, information on the costs of post-stroke readmissions has not been systematically reviewed.
To systematically review information about the costs of hospital readmissions of patients whose primary diagnosis in the index admission was a stroke.
A rapid systematic review was performed on studies reporting post-stroke readmission costs in EMBASE, MEDLINE, and Web of Science up to June 2021. Relevant data were extracted and presented by readmission and stroke type. The original study's currency values were converted to 2021 US dollars based on the purchasing power parity for gross domestic product. The reporting quality of each of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
Forty-four studies were identified. Considerable variability in readmission costs was observed among countries, readmissions, stroke types, and durations of the follow-up period. The UK and the USA were the countries reporting the highest readmission costs. In the first year of follow-up, stroke readmission costs accounted for 2.1-23.4%, of direct costs and 3.3-21% of total costs. Among the included studies, only one identified predictors of readmission costs.
Our review showed great variability in readmission costs, mainly due to differences in study design, countries and health services, follow-up duration, and reported readmission data. The results of this study can be used to inform policymakers and healthcare providers about the burden of stroke readmissions. Future studies should not solely focus on improving data standardization but should also prioritize the identification of stroke readmission cost predictors.
卒中再入院被视为健康质量的一个指标，可能给医疗系统带来负担。然而，关于卒中后再入院成本的信息尚未得到系统综述。
系统综述首次入院时主要诊断为卒中的患者再次入院成本的相关信息。
对截至2021年6月在EMBASE、MEDLINE和科学网中报告卒中后再入院成本的研究进行快速系统综述。提取相关数据，并按再入院情况和卒中类型呈现。根据国内生产总值购买力平价将原始研究的货币价值换算为2021年美元。使用《卫生经济评价报告标准合并清单》（CHEERS）评估纳入的每项研究的报告质量。
共识别出44项研究。在不同国家、再入院情况、卒中类型以及随访期时长之间，再入院成本存在很大差异。英国和美国是报告再入院成本最高的国家。在随访的第一年，卒中再入院成本占直接成本的2.1%至23.4%，占总成本的3.3%至21%。在纳入的研究中，只有一项研究确定了再入院成本的预测因素。
我们的综述显示再入院成本差异很大，主要原因在于研究设计、国家和卫生服务、随访时长以及报告的再入院数据存在差异。本研究结果可用于告知政策制定者和医疗服务提供者卒中再入院的负担情况。未来研究不应仅专注于改善数据标准化，还应优先确定卒中再入院成本的预测因素。
