Cost-benefit evaluation of comprehensive medical care for cerebral strokes

Sekita, Yasuyoshi

doi:10.3109/14639238509010027

Medical Informatics

1985

DOI: 10.3109/14639238509010027

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Cost-benefit evaluation of comprehensive medical care for cerebral strokes

Yasuyoshi Sekita

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1992

2000

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Cited by 2 publications

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Cost-effectiveness of stroke prevention

Ebrahim

2000

British Medical Bulletin

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Stroke is a preventable disease and there are several interventions that might have an important role in reducing the burden of disease. Economic appraisal of these different interventions is essential as resources are scarce and it is logical to attempt to obtain the greatest reduction in disease for the lowest cost. Anticoagulation for non-rheumatic atrial fibrillation is highly effective, but is expensive and cost-effectiveness analyses show that use of aspirin alone would prevent almost as many strokes at much lower cost. Antiplatelet drugs are both effective and inexpensive and their use in secondary prevention would potentially save the NHS about 900 Pounds per life year gained. Carotid endarterectomy and the associated screening costs are poor value for money but recent attempts to use predictive models to determine which patients will benefit from surgery may improve its cost-effectiveness. Current evidence is dominated by pharmacological interventions and much less good evidence is available for life-style modifications such as dietary change and physical exercise. Modification of major cardiovascular risk factors (blood cholesterol, high blood pressure and smoking) is very cost-effective but needs to be better targeted if potential health gain is to be realised.

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Cost-effectiveness of stroke prevention

Ebrahim

2000

British Medical Bulletin

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Cost-Effective Intervention in Stroke

Dunbabin

1992

PharmacoEconomics

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A rigorous assessment of current practice in all branches of medicine is necessary to ensure that we are minimising the costs and maximising the effectiveness of management and treatment. This is especially important in cerebrovascular disease which imposes a large burden of death; it is the third commonest cause of death after cancer and heart disease in most developed countries, and the commonest cause of long term disability on society. Stroke consumes up to 5% of healthcare expenditure in developed countries, and costs can be expected to remain static or increase with an increase in the proportion of elderly (who are at high risk of stroke) in the community over coming decades. This article reviews the epidemiology of stroke (risk factors, incidence, prevalence and the burden of disability and handicap), the various studies dealing with the community and individual costs of stroke, and the cost-effectiveness of interventions to prevent stroke such as control of hypertension, reduction in cigarette intake, encouragement of a healthy lifestyle, antiplatelet or anticoagulant therapy, and carotid endarterectomy. Acute treatment of stroke remains an area of major potential therapeutic benefit, but no widely applicable therapy currently exists, although many treatments are being investigated. Rehabilitation after stroke is costly, but may result in significant reduction in disability and handicap with reduced need for long term institutional care. The clinical implications of these studies and the potential for future research are also discussed.

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Cost-benefit evaluation of comprehensive medical care for cerebral strokes

Cited by 2 publications

References 11 publications

Cost-effectiveness of stroke prevention

Cost-effectiveness of stroke prevention

Cost-Effective Intervention in Stroke

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