Economic Burden of Intracranial Vascular Malformations in Adults

Miller, Clare E.; Quayyum, Zahidul; McNamee, Paul; Salman, Rustam Al-Shahi

doi:10.1161/strokeaha.108.539528

Cited by 31 publications

(15 citation statements)

References 21 publications

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“…In some European countries, this incidence is predicted to increase until 20206 ) . Better management of the disease has enabled long-term survival of stroke patients; however, the associated increase in the number of patients, along with their families has resulted in an increase in social and economic burdens7,8,9 ) .…”

Section: Introductionmentioning

confidence: 99%

Effects of Sling Exercise Therapy on Trunk Muscle Activation and Balance in Chronic Hemiplegic Patients

Lee¹,

Lee

2014

J Phys Ther Sci

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Weakening of trunk muscles in stroke patients hinders functional ability, safety and balance. To confirm whether strengthening trunk muscles could facilitate rehabilitation of stroke patients, we investigated the effectiveness of sling exercise therapy (SET) using closed kinetic chain exercises to activate trunk muscles and improve balance in stroke patients. [Subjects and Methods] Twenty stroke patients with chronic hemiplegia were equally divided into 2 groups, a SET group and a control group that performed regular exercises on a mat with the assistance of a table. Patients in both groups exercised for 30 min, three times per week for 4 weeks. Trunk muscle activity was measured using surface electromyography, whereas balance was measured using the Berg Balance Scale, Frailty and Injuries Cooperative Studies of Intervention Technique, Timed Up & Go test, and BioRescue before and after the 4-week experimental period. [Results] Trunk muscle activity and balance before and after intervention in both groups were significantly different. However, no significant differences were observed between the 2 groups. [Conclusion] Although SET was not more effective than regular exercise, significant improvement was observed before and after SET. Therefore, SET can be considered effective in strengthening trunk muscles in stroke patients with chronic hemiplegia.

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Section: Introductionmentioning

confidence: 99%

Effects of Sling Exercise Therapy on Trunk Muscle Activation and Balance in Chronic Hemiplegic Patients

Lee¹,

Lee

2014

J Phys Ther Sci

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“…With an average of almost $300 million of inpatient charges per year, the management of IVMs has economic significance in public health. Not included are costs from the outpatient setting and lost productivity [27]. …”

Section: Discussionmentioning

confidence: 99%

Trends in the Management of Intracranial Vascular Malformations in the USA from 2000 to 2007

Choi

Pile‐Spellman

Brisman

2012

Stroke Research and Treatment

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Objective. To assess prevalence, clinical characteristics, trends in treatment pattern, and outcome in patients with intracranial vascular malformations (IVMs). Methods. Nationwide inpatient sample. Patients with the diagnosis of an IVM admitted to US hospitals from 2000 to 2007. Results. In 58,051 IVM-related admissions (detection rate 2.4/100,000 person-years; mean age 49 ± 17 years; 52% women) major diagnoses were intracranial hemorrhage (ICrH) in 15%, seizure 32%, ischemia 5%, and headache 9%. Procedures included surgery (13%), embolization (13%), radiation therapy (2%), aneurysm clipping (1%), and mechanical ventilation (6%). Ventilation and ICrH were associated with death (2%), whereas ventilation, ICrH, surgery, seizure, and ischemia were associated with unfavorable outcome (20%). IVM detection rate and hospital outcome remained stable over time, whereas mean age and comorbid diagnosis of cerebral ischemia increased (ICrH and seizure decreased). Conclusion. IVMs are infrequent and present in 1/6 patients with some form of ICrH. Overall, seizure is the dominant comorbid diagnosis (1/3 patients). IVMs are equally prevalent among race-ethnic groups and are increasingly detected later in life. The inpatient care of IVM patients results in death or discharge into specialized care in 1/5 patients.

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“…Identified costing methods are based on three broad schemes, which differ in their underlying assumptions. A review of the literature on costing acute inpatient care, both in the UK and worldwide, had identified diagnosisrelated group (DRG) costing (or the respective national equivalent) (Anandan et al, 2009;Maheshwari et al, 2010;Lorgelly et al, 2010;Poole et al, 2010) and per diem costing, which are mainly used in economic evaluations, (Gray et al, 2001;Lui et al, 2002;Stewart et al, 2002;Walker et al, 2003;Christensen and Munro, 2008;Harjola et al, 2009;Miller et al, 2009;Ringborg et al, 2009) as the two most commonly applied approaches. These also can be employed in combination, for example, Hakkinen et al (2008) used the average cost per inpatient day specific to each DRG (NordDRG).…”

Section: Review Of Costing Methodsmentioning

confidence: 99%

Spoilt for Choice: Implications of Using Alternative Methods of Costing Hospital Episode Statistics

et al. 2011

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In the absence of a 'gold standard' to estimate the economic burden of disease, a decision about the most appropriate costing method is required. Researchers have employed various methods to cost hospital stays, including per diem or diagnosis-related group (DRG)-based costs. Alternative methods differ in data collection and costing methodology. Using data from Scotland as an illustrative example, costing methods are compared, highlighting the wider implications for other countries with a publicly financed healthcare system. Five methods are compared using longitudinal data including baseline survey data (Midspan) linked to acute hospital admissions. Cost variables are derived using two forms of DRG-type costs, costs per diem, costs per episode-using a novel approach that distinguishes between variable and fixed costs and incorporates individual length of stay (LOS), and costs per episode using national average LOS. Cost estimates are generated using generalised linear model regression. Descriptive analysis shows substantial variation between costing methods. Differences found in regression analyses highlight the magnitude of variation in cost estimates for subgroups of the sample population. This paper emphasises that any inference made from econometric modelling of costs, where the marginal effect of explanatory variables is assessed, is substantially influenced by the costing method.

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Economic Burden of Intracranial Vascular Malformations in Adults

Cited by 31 publications

References 21 publications

Effects of Sling Exercise Therapy on Trunk Muscle Activation and Balance in Chronic Hemiplegic Patients

Effects of Sling Exercise Therapy on Trunk Muscle Activation and Balance in Chronic Hemiplegic Patients

Trends in the Management of Intracranial Vascular Malformations in the USA from 2000 to 2007

Spoilt for Choice: Implications of Using Alternative Methods of Costing Hospital Episode Statistics

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