Estimating the effectiveness and cost-effectiveness of establishing additional endovascular Thrombectomy stroke Centres in England: a discrete event simulation

Autor:	Darren Flynn, Hannah Lumley, Martin James, Peter McMeekin, David Burgess, Joyce S. Balami, Diarmuid Coughlan, Michael Allen, Ken Stein, Phil White, Gary A. Ford
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	Budgets Male medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis Ambulatory Care Facilities B700 State Medicine Health administration Time-to-Treatment Predictive models 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Medicine Humans Acute stroke 030212 general & internal medicine Discrete event simulation Stroke Aged Thrombectomy Health economics business.industry Health Policy Incidence (epidemiology) lcsh:Public aspects of medicine Endovascular Procedures lcsh:RA1-1270 Middle Aged medicine.disease Hospitals B900 Hospitalization Treatment Outcome England Emergency medicine Female Quality-Adjusted Life Years business Delivery of Health Care 030217 neurology & neurosurgery Research Article
Zdroj:	BMC Health Services Research, Vol 19, Iss 1, Pp 1-11 (2019) BMC Health Services Research
ISSN:	1472-6963
DOI:	10.1186/s12913-019-4678-9
Popis:	Background We have previously modelled that the optimal number of comprehensive stroke centres (CSC) providing endovascular thrombectomy (EVT) in England would be 30 (net 6 new centres). We now estimate the relative effectiveness and cost-effectiveness of increasing the number of centres from 24 to 30. Methods We constructed a discrete event simulation (DES) to estimate the effectiveness and lifetime cost-effectiveness (from a payer perspective) using 1 year’s incidence of stroke in England. 2000 iterations of the simulation were performed comparing baseline 24 centres to 30. Results Of 80,800 patients admitted to hospital with acute stroke/year, 21,740 would be affected by the service reconfiguration. The median time to treatment for eligible early presenters ( Conclusion Changes in acute stroke service configuration will produce clinical and cost benefits when the time taken for patients to receive treatment is reduced. Benefits are highly likely to be cost saving over 5 years before any capital investment above £8 million is required.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a67ec6b9a3da9e3c5099fd237ad1be66 http://link.springer.com/article/10.1186/s12913-019-4678-9 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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