A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change

Abstract

Background: Stroke is a significant burden in Saudi Arabia and the Saudi Ministry of Health's stroke committee has identified an urgent need to improve care.Aim: The purpose of this study was to undertake a health-economic analysis to quantify the impact of developing stroke care in the country.Methods: An economic model was developed to assess the costs and clinical outcomes associated with an ischemic stroke care development program compared with current stroke care. Based on Saudi epidemiological data, cohorts of ischemic stroke patients enter the model each year for the first 10 years based on increasing incidence. Four treatment options were modeled including reperfusion and non-reperfusion treatments. The development scenario estimates the impact of gradually increasing uptake of more effective treatments over 10 years. Changes in the stroke care organization are considered along with resources required to increase capacity, allowing more patients to be admitted to stroke hospitals and access effective treatments.Results: The stroke care development program is associated with an increase in functionally independent patients and a decrease in disabling strokes compared with current stroke care. Additionally, the development program is associated with estimated cost savings of $602 million over 15 years ($255 million direct costs, $348 million indirect costs). Conclusions:The model predicts that the stroke care development program is associated with improved patient outcomes and lower overall costs compared with the current stroke care program.

A Systematic Review of Sources of Outcomes and Cost Data Utilized in Economic Evaluation Research Conducted in the Gulf Cooperation Council

“… 18 , 19 The majority of the studies evaluated costs from the health-care system perspective, which refers to a variety of bodies, including hospitals (n = 8) 17 , 20 , 23 , 24 , 26 , 27 , 29 , 30 or public payers (n = 1), 28 with one additionally considering the societal perspective. 30 Societal (n = 2) 22 , 25 and patient (n = 1) 21 perspectives were also adopted.…”

“…The costing year was explicitly reported in 10 studies; the remaining studies reported the year for the conversion rate. 18 , 19 , 24 , 25 A variety of currency data was reported: Five studies used both the local currency and international dollars, 18 , 19 , 23 , 29 , 30 five studies used international dollars, 17 , 21 , 25–27 and the remaining four studies used the local currency. 20 , 22 , 24 , 28 …”

A cross-sectional study of awareness regarding dog bite and its management in rural community of Maharashtra, India

“…Despite the convincing evidence for thrombolysis in the management of acute stroke, particularly during the first 4.5 hours, Saudi Arabia struggles to move from traditional stroke care, with approximately 95% of patients being cared for at nonspecialized stroke hospitals and not receive any reperfusion therapy. 9 In Saudi Arabia, the estimated proportion of eligible stroke patients who received IV t-PA is still <1%, although it is currently standard care and has been approved since 1996. 9 One of the major challenges is the shortage of neurologists.…”

“…9 In Saudi Arabia, the estimated proportion of eligible stroke patients who received IV t-PA is still <1%, although it is currently standard care and has been approved since 1996. 9 One of the major challenges is the shortage of neurologists. A previous study conducted in Saudi Arabia in 2011 reported that there were solely 83 practicing neurologists working in Saudi Arabia at that time, almost half of whom practiced in the capital city of Riyadh.…”

Secondary stroke prevention among stroke survivors in Riyadh city, Saudi Arabia

“…5 Furthermore, stroke care is still suboptimal as compared to developed countries, 6 and there is a lack of robust organizational processes of care and inadequate allocation of resources. 6,7 This would in turn cause significant consequences in the affected patients.…”