The cost of providing mechanical thrombectomy in the UK NHS: a micro-costing study
| Autor: | Rachael Jones, Stephen Rice, Anand Dixit, Alastair Gray, Sanjeev Nayak, Lisa Foddy, Dawn Craig, Kurdow Nader, Robert Simister, Christine Roffe, Indira Natarajan, Joyce S. Balami, Hannah Lumley, Gary A. Ford, Darren Flynn, Phil White, Don Sims, David Burgess, Ivan Wiggam, Alastair M. Buchan, Beverley Hudson, Diamuid Coughlan, Martin James, J Chembala, Yazen Sammaraiee, Emer Hopkins, Peter Flynn, Peter McMeekin |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Total cost 030204 cardiovascular system & hematology State Medicine law.invention B800 Brain Ischemia 03 medical and health sciences 0302 clinical medicine law medicine Humans General anaesthesia 030212 general & internal medicine Stroke Reimbursement Retrospective Studies Thrombectomy Original Research Inpatient care business.industry Retrospective cohort study General Medicine A300 medicine.disease Intensive care unit Confidence interval United Kingdom B900 Emergency medicine business |
| Zdroj: | Clin Med (Lond) BASE-Bielefeld Academic Search Engine |
| ISSN: | 1473-4893 1470-2118 |
| Popis: | Introduction The clinical efficacy and cost-effectiveness of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke is well established, but uncertainty remains around the true cost of delivering this treatment within the NHS. The aim of this study was to establish the cost of providing MT within the hyperacute phase of care and to explore differences in resources used and costs across different neuroscience centres in the UK. Method This was a multicentre retrospective study using micro-costing methods to enable a precise assessment of the costs of MT from an NHS perspective. Data on resources used and their costs were collected from five UK neuroscience centres between 2015 and 2018. Results Data were collected on 310 patients with acute ischaemic stroke treated with MT. The mean total cost of providing MT and inpatient care within 24 hours was £10,846 (95% confidence interval (CI) 10,527–11,165) per patient. The main driver of cost was MT procedure costs, accounting for 73% (£7,943; 95% CI 7,649–8,237) of the total 24-hour cost. Costs were higher for patients treated under general anaesthesia (£11,048; standard deviation (SD) 2,654) than for local anaesthesia (£9,978; SD 2,654), mean difference £1,070 (95% CI 381–1,759; p=0.003); admission to an intensive care unit (ICU; £12,212; SD 3,028) against for admission elsewhere (£10,179; SD 2,415), mean difference £2,032 (95% CI 1,345–2,719; p The mean cost within 72 hours was £12,440 (95% CI 10,628–14,252). The total costs for the duration of inpatient care before discharge from a thrombectomy centre was £14,362 (95% CI 13,603–15,122). Conclusions Major factors contributing to costs of MT for stroke include consumables and staff for intervention, use of general anaesthesia and ICU admissions. These findings can inform the reimbursement, provision and strategic planning of stroke services and aid future economic evaluations. |
| Databáze: | OpenAIRE |
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