Cost-effectiveness of home-based stroke rehabilitation across Europe: A modelling study

被引:14
作者
Candio, Paolo [1 ,2 ]
Violato, Mara [1 ]
Luengo-Fernandez, Ramon [1 ]
Leal, Jose [1 ]
机构
[1] Univ Oxford, Hlth Econ Res Ctr, Nuffield Dept Populat Hlth, Richard Doll Bldg,Old Rd Campus, Oxford OX3 7LF, England
[2] Univ Birmingham, Ctr Econ Obes, Edgbaston Campus, Birmingham, W Midlands, England
关键词
Rehabilitation; Stroke; Cost-effectiveness; Europe; Decision-making; HEALTH; RECOMMENDATIONS;
D O I
10.1016/j.healthpol.2022.01.007
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The aim of this study was to explore the cost-effectiveness of home-based versus centre-based rehabilitation in stroke patients across Europe. A state-transition cohort model was developed to simulate the impact of the intervention in 32 European countries. A cost-utility analysis was conducted from a societal perspective including healthcare, social care and informal care costs, and productivity losses. Health outcomes were expressed as QALYs. Sensitivity analyses were conducted concerning model input values and structural assumptions. Data were obtained from a population-based cohort and previously published studies. Across Europe, over 855,0 0 0 patients with stroke would be eligible for rehabilitation in 2017. Europe-wide implementation of home-based rehabilitation was estimated to produce 61,888 additional QALYs (95% CI: 3,609 to 118,679) and cost savings of (sic)237 million (95% CI:-237 to 1,764) and of Euro352 million (95% CI:-340 to 2,237) in health-and social-care and societal costs, respectively. Under base case assumptions, home-based rehabilitation was found highly likely to be cost-effective (> 90%), compared to centre-based rehabilitation, in most European countries (29 out of 32). Evidence from this study suggests that a shift from a centre-based to a home-based approach to stroke rehabilitation is likely to be good value for money in most European countries. Further research should be conducted to assess the generalisability of these findings to local settings. (C) 2022 Elsevier B.V. All rights reserved.
引用
收藏
页码:183 / 189
页数:7
相关论文
共 42 条
[1]   Assessing the impact of a home-based stroke rehabilitation programme: a cost-effectiveness study [J].
Allen, Laura ;
John-Baptiste, Ava ;
Meyer, Matthew ;
Richardson, Marina ;
Speechley, Mark ;
Ure, David ;
Markle-Reid, Maureen ;
Teasell, Robert .
DISABILITY AND REHABILITATION, 2019, 41 (17) :2060-2065
[2]   Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective [J].
Angerova, Yvona ;
Marsalek, Pavel ;
Chmelova, Irina ;
Gueye, Tereza ;
Uherek, Stepan ;
Briza, Jan ;
Bartak, Miroslav ;
Rogalewicz, Vladimir .
INTERNATIONAL JOURNAL OF REHABILITATION RESEARCH, 2020, 43 (04) :376-382
[3]  
[Anonymous], 2013, CG162 NAT I HLTH CAR
[4]  
[Anonymous], 2008, STROK DIAGN IN MAN A
[5]   Probabilistic sensitivity analysis in health economics [J].
Baio, Gianluca ;
Dawid, A. Philip .
STATISTICAL METHODS IN MEDICAL RESEARCH, 2015, 24 (06) :615-634
[6]   Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an inner-London teaching hospital [J].
Beech, R ;
Rudd, AG ;
Tilling, K ;
Wolfe, CDA .
STROKE, 1999, 30 (04) :729-735
[7]   Data Resource Profile: The Survey of Health, Ageing and Retirement in Europe (SHARE) [J].
Boersch-Supan, Axel ;
Brandt, Martina ;
Hunkler, Christian ;
Kneip, Thorsten ;
Korbmacher, Julie ;
Malter, Frederic ;
Schaan, Barbara ;
Stuck, Stephanie ;
Zuber, Sabrina .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2013, 42 (04) :992-1001
[8]  
Briggs A., 2006, DECISION MODELLING H
[9]   Medical day hospital care for older people versus alternative forms of care [J].
Brown, Lesley ;
Forster, Anne ;
Young, John ;
Crocker, Tom ;
Benham, Alex ;
Langhorne, Peter .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2015, (06)
[10]   Cost-Effectiveness of Mechanical Thrombectomy for Treatment of Nonminor Ischemic Stroke Across Europe [J].
Candio, Paolo ;
Violato, Mara ;
Leal, Jose ;
Luengo-Fernandez, Ramon .
STROKE, 2021, 52 (02) :664-673