López-Romero Luis Alberto, Parra Dora Inés, Aguilar Alexandra Cortés, Camargo Figuera Fabio Alberto
PhD student in Biomedical Research Methodology and Public Health, Universidad Autónoma de Barcelona, Universidad Industrial de Santander, Bucaramanga, Colombia.
PhD in Clinical and Community Nursing Programme, University de Valencia, Spain.
Public Health Pract (Oxf). 2025 May 10;9:100617. doi: 10.1016/j.puhip.2025.100617. eCollection 2025 Jun.
Tele-Stroke has been proposed as a solution to increase access to thrombolytic therapy in acute ischemic stroke. : Synthesise the evidence of the cost-effectiveness of Tele-Stroke. : Systematic Literature Review.
Systematic review of cost-effectiveness economic evaluations of Tele-Stroke from the Centre for Reviews and Dissemination of the University of York, International HTA Database, PubMed, EMBASE, Cochrane Library, Cost-Effectiveness Analysis Registry, National Institute for Health and Care Excellence, The European Network of Health Economic Evaluation Databases Project and grey literature. Quality assessment, data selection and data extraction were performed by two reviewers. A qualitative synthesis was conducted.
Twelve studies, published between 2008 and 2022 in high-income countries were included; 50.00 % were conducted from a health system perspective and the most frequent discount rate was 3 %. Spoke/Hub ratio ranged from 1:1 to 17:2. In 5/12 studies Tele-Stroke was found to be highly cost-effective (dominant intervention: lower cost and higher effectiveness) and only two acceptable (lower cost and lower effectiveness). Incremental Cost Effectiveness Ratio (ICER) per Quality-Adjusted Life Years (QALY) gained ranged from US$ 290,368.77 to US$ 327.44 in 2022. : Most of the studies showed that the Tele-Stroke programme could be a cost-effective strategy, both from a social and health system perspective; however, most of the studies were from middle-and-high-income countries, which requires analysis before implementation in low-income countries.
远程卒中已被提议作为一种增加急性缺血性卒中溶栓治疗可及性的解决方案。：综合远程卒中成本效益的证据。：系统文献综述。
对来自约克大学综述与传播中心、国际卫生技术评估数据库、PubMed、EMBASE、考科蓝图书馆、成本效益分析注册库、英国国家卫生与临床优化研究所、欧洲卫生经济评估数据库项目网络以及灰色文献的远程卒中成本效益经济评估进行系统综述。由两名评审员进行质量评估、数据筛选和数据提取。进行定性综合分析。
纳入了2008年至2022年间在高收入国家发表的12项研究；50.00%是从卫生系统角度开展的，最常见的贴现率为3%。辐辏/中枢比例从1:1到17:2不等。在12项研究中的5项中，远程卒中被发现具有高成本效益（占优干预：成本更低且效果更佳），只有两项可接受（成本更低且效果更差）。2022年每获得一个质量调整生命年（QALY）的增量成本效益比（ICER）在290,368.77美元至327.44美元之间。：大多数研究表明，远程卒中项目从社会和卫生系统角度来看可能是一种具有成本效益的策略；然而，大多数研究来自中高收入国家，在低收入国家实施前需要进行分析。
