Association Between Disability Measures and Healthcare Costs After Initial Treatment for Acute Stroke
| Autor: | Hans-Christoph Diener, Jesse Dawson, Myzoon Ali, Kennedy R. Lees, Matthew Walters, Jennifer S Lees, Tou Pin Chang, Stephen M. Davis |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Severity of Illness Index Disability Evaluation symbols.namesake Modified Rankin Scale Outcome Assessment Health Care Health care Severity of illness Humans Multicenter Studies as Topic Medicine Association (psychology) Stroke Aged Randomized Controlled Trials as Topic Acute stroke Aged 80 and over Advanced and Specialized Nursing business.industry Health Care Costs Length of Stay medicine.disease Bonferroni correction Acute Disease symbols Physical therapy Female Neurology (clinical) Analysis of variance Cardiology and Cardiovascular Medicine business |
| Zdroj: | Stroke. 38:1893-1898 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background and Purpose— The distribution of 3-month modified Rankin scale (mRS) scores has been used as an outcome measure in acute stroke trials. We hypothesized that hospitalization and institutional care home stays within the first 90 days after stroke should be closely related to 90-day mRS, that each higher mRS category will reflect incremental cost, and that resource use may be less clearly linked to the National Institutes of Health Stroke Scale (NIHSS) or Barthel index. Methods— We examined resource use data from the GAIN International trial comparing 90-day mRS with total length of stay in hospital or other institutions during the first 90 days. We repeated analyses using NIHSS and Barthel index scores. Relationships were examined by analysis of variance (ANOVA) with Bonferroni contrasts of adjacent score categories. Estimated costs were based on published Scottish figures. Results— We had full data from 1717 patients. Length of stay was strongly associated with final mRS ( P P Conclusions— Each mRS category reflects different average length of hospital and institutional stay. Associated costs are meaningfully different across the full range of mRS outcomes. Analysis of the full distribution of mRS scores is appropriate for interpretation of treatment effects after acute stroke and more informative than Barthel or NIHSS end points. |
| Databáze: | OpenAIRE |
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