Effectiveness and cost-effectiveness of TeleStroke consultations to support the care of patients who had a stroke presenting to regional emergency departments in Western Australia: an economic evaluation case study protocol.

Autor:	Tsou C; School of Public Health, Curtin University, Bentley, Western Australia, Australia christina.tsou@curtin.edu.au., Robinson S; School of Public Health, Curtin University, Bentley, Western Australia, Australia., Boyd J; School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia., Kamath S; Western Australia Country Health Service, Perth, Western Australia, Australia., Yeung J; Western Australia Country Health Service, Perth, Western Australia, Australia., Waters S; Western Australia Country Health Service, Perth, Western Australia, Australia., Gifford K; Western Australia Country Health Service, Perth, Western Australia, Australia., Jamieson A; Western Australia Country Health Service, Perth, Western Australia, Australia., Hendrie D; School of Public Health, Curtin University, Bentley, Western Australia, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Jan 06; Vol. 11 (1), pp. e043836. Date of Electronic Publication: 2021 Jan 06.
DOI:	10.1136/bmjopen-2020-043836
Abstrakt:	Introduction: The Western Australia (WA) Acute TeleStroke Programme commenced incrementally across regional WA during 2016-2017. Since the introduction of the TeleStroke Programme, there has been monitoring of service outputs, including regional patient access to tertiary stroke specialist advice and reperfusion treatment; however, the impact of consultation with a stroke specialist via telehealth (videoconferencing or telephone) on the effectiveness and cost-effectiveness of stroke care and the drivers of cost-effectiveness has not been systematically evaluated. Methods and Analysis: The aim of the case study was to examine the impact of consultation with a stroke specialist via telehealth on the effectiveness and cost-effectiveness of stroke and transient ischaemic attack care using a mixed methods approach. A categorical decision tree model will be constructed in collaboration with clinicians and programme managers. A before and after comparison using state-wide administrative datasets will be used to run the base model. If sample size and statistical power permits, the cases and comparators will be matched by stroke type and presence of CT scan at the initial site of presentation, age category and presenting hospital. The drivers of cost-effectiveness will be explored through stakeholder interviews. Data from the qualitative analysis will be cross-referenced with trends emerging from the quantitative dataset and used to guide the factors to be involved in subgroup and sensitivity analysis. Ethics and Dissemination: Ethics approval for this case study has been granted from the Western Australian Country Health Service Human Research and Ethics Committee (RGS3076). Reciprocal approval has been granted from Curtin University Human Research Ethics Office (HRE2019-0740). Findings will be disseminated publicly through conference presentation and peer-review publications. Interim findings will be released as internal reports to inform the service development. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu