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J Stroke Cerebrovasc Dis. 2017 Oct;26(10):2362-2368. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.025. Epub 2017 Jun 13.

The Cost-Effectiveness of a Stroke Unit in Providing Enhanced Patient Outcomes in an Australian Teaching Hospital.

Author information

1
St Vincent's Hospital, Sydney, Australia.
2
Calvary Hospital, Bruce, Canberra, Australia; Charles Sturt University, Bathurst, Australia. Electronic address: gus_gardiner@hotmail.com.
3
Australian National University, Canberra, Australia.
4
The Canberra Hospital, Canberra, Australia.
5
Calvary Hospital, Bruce, Canberra, Australia; Australian National University, Canberra, Australia.

Abstract

BACKGROUND:

Stroke is one of the leading causes of disability and mortality. Patients who receive organized inpatient care in a stroke unit (SU) have better clinical outcomes. However, evidence on the cost analysis of an SU is lacking. The objective of this study was to assess the performance and analyze the cost-effectiveness of an SU.

METHODS:

A retrospective observational study was conducted comparing the acute stroke patient care in a 6-month period before and after the establishment of an acute SU at Calvary Hospital in 2013-2014.

RESULTS:

There were 103 patients included in the pre-SU period, as compared to 186 patients in the post-SU period. In the pre- and post-SU groups, 54 and 87 patients, respectively, had ischemic stroke, with significant trends in improved morbidity and mortality in the post-SU group (P = .01). The average length of stay (LOS) for patients was reduced from 9.7 days to 4.6 days in the post-SU group (P = .001). There was a reduction of cost per admission from $6382 Australian dollars (AUD) with conventional ward care as compared to $6061 (AUD) with SU care.

CONCLUSION:

This study confirmed that the establishment of an SU not only improves treatment outcomes but also shortens LOS, thereby achieving cost-effectiveness.

KEYWORDS:

Australia; Stroke; cost-effectiveness; length of stay; stroke management; stroke unit

[Indexed for MEDLINE]

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