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The economic burden of stroke care in England, Wales and Northern Ireland: using a national stroke register to estimate and report patient level health economic outcomes in stroke

Research output: Contribution to journalArticle

SSNAP collaboration, Xiang-Ming Xu, Emma Vestesson, Lizz Paley, Anita Desikan, David Wonderling, Alex Hoffman, Charles D A Wolfe, Anthony G Rudd, Benjamin D Bray

Original languageEnglish
Pages (from-to)82-91
JournalEuropean Stroke Journal
Volume3
Issue number1
Early online date30 Nov 2017
DOIs
Publication statusPublished - 2018

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King's Authors

Abstract

Introduction: Stroke registries are used in many settings to measure stroke treatment and outcomes, but rarely include
data on health economic outcomes. We aimed to extend the Sentinel Stroke National Audit Programme registry of
England, Wales and Northern Ireland to derive and report patient-level estimates of the cost of stroke care.
Methods: An individual patient simulation model was built to estimate health and social care costs at one and five years
after stroke, and the cost-benefits of thrombolysis and early supported discharge. Costs were stratified according to age,
sex, stroke type (ischaemic or primary intracerebral haemorrhage) and stroke severity. The results were illustrated using
data on all patients with stroke included in Sentinel Stroke National Audit Programme from April 2015 to March 2016
(n ¼ 84,184).
Results: The total cost of health and social care for patients with acute stroke each year in England, Wales and Northern
Ireland was £3.60 billion in the first five years after admission (mean per patient cost: £46,039). There was fivefold
variation in the magnitude of costs between patients, ranging from £19,101 to £107,336. Costs increased with older age,
increasing stroke severity and intracerebral hemorrhage stroke. Increasing the proportion of eligible patients receiving
thrombolysis or early supported discharge was estimated to save health and social care costs by five years after stroke.
Discussion: The cost of stroke care is large and varies widely between patients. Increasing the proportion of eligible
patients receiving thrombolysis or early supported discharge could contribute to reducing the financial burden of stroke.
Conclusion: Extending stroke registers to report individualised data on costs may enhance their potential to support
quality improvement and research.

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