Cost analysis of early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic

Abstract

Objectives: The paper analyses real-world data on cost of treatment in patients after stroke hospitalized in early rehabilitation units within comprehensive stroke centres in the Czech Republic. This is the first study of the kind in the Czech Republic, while such information is extremely rare worldwide. Stroke treatment witnessed a dramatic development in the last years, when the main progress was due to establishment of specialized (comprehensive) stroke units incorporating also early rehabilitation. There is a general agreement among clinicians that early rehabilitation is beneficial for patients after stroke.Methods: Costs of early rehabilitation after stroke were calculated by the micro-costing method alongside a pragmatic study in three Czech hospitals. Patients were transferred to specialized early rehabilitation units usually on 7th to 14th day after stroke onset and received four hours of interprofessional rehabilitation per day.Results: The analysis of data collected during the prospective observational research of 87 patients proved significant differences between patients. The average costs of hospitalization were determined to be CZK 5,104 (EUR 194) per one day of intensive rehabilitation in seriously affected patients early after stroke. These costs differed significantly between hospitals (p-value < 0.001); the structure of direct costs was quite stable, though. About 60% of these costs were due to nursing and overhead, while no more than 15% were consumed by therapists.Conclusions: The treatment of patients after stroke in specialized stroke units proved to be beneficial for the patients increasing the number of those re-integrated in family and community life.

Early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic: a comparison of three stroke units

“…The study was approved by the Ethics Committee of the General University Hospital in Prague on 15th December 2016. The detailed design of the study was published together with its first results (Angerova et al, 2020;2021). The study had a pragmatic design and the individual hospitals followed their standard clinical management procedures and processes.…”

“…The objective of this study was to calculate hospitalization costs in patients after stroke during the early rehabilitation therapy at stroke units. The main economic results have been recently published (Angerova et al, 2020;2021). The study was carried out in three backbone Czech hospitals in Prague, Ústí nad Labem and Ostrava.…”

Efficacy of early integrated rehabilitation therapy on treatment outcomes and limb functional recovery in patients with cerebral embolism: An observational study

“…[ 9 ] Speech and language therapy aims to recover communication abilities, and psychological support addresses the emotional and behavioral challenges that may arise poststroke. [ 10 ] This integrated approach is designed to be patient-centered, addressing the comprehensive needs of stroke survivors. [ 11 ] The rationale for early intervention lies in the concept of neural plasticity – the brain’s ability to reorganize and adapt following injury.…”