Value of treatment by comprehensive stroke services for the reduction of critical gaps in acute stroke care in Europe Article Swipe
YOU?
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· 2020
· Open Access
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· DOI: https://doi.org/10.1111/ene.14583
Stroke is the second leading cause of death and dependency in Europe and costs the European Union more than €30bn, yet significant gaps in the patient pathway remain and the cost‐effectiveness of comprehensive stroke care to meet these needs is unknown. The European Brain Council Value of Treatment Initiative combined patient representatives, stroke experts, neurological societies and literature review to identify unmet needs in the patient pathway according to Rotterdam methodology. The cost‐effectiveness of comprehensive stroke services was determined by a Markov model, using UK cost data as an exemplar and efficacy data for prevention of death and dependency from published systematic reviews and trials, expressing effectiveness as quality‐adjusted life‐years (QALYs). Model outcomes included total costs, total QALYs, incremental costs, incremental QALYs and the incremental cost‐effectiveness ratio (ICER). Key unmet needs in the stroke patient pathway included inadequate treatment of atrial fibrillation (AF), access to neurorehabilitation and implementation of comprehensive stroke services. In the Markov model, full implementation of comprehensive stroke services was associated with a 9.8% absolute reduction in risk of death of dependency, at an intervention cost of £9566 versus £6640 for standard care, and long‐term care costs of £35 169 per 5.1251 QALYS vs. £32 347.40 per 4.5853 QALYs, resulting in an ICER of £5227.89. Results were robust in one‐way and probabilistic sensitivity analyses. Implementation of comprehensive stroke services is a cost‐effective approach to meet unmet needs in the stroke patient pathway, to improve acute stroke care and support better treatment of AF and access to neurorehabilitation.
Related Topics
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1111/ene.14583
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ene.14583
- OA Status
- bronze
- Cited By
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- References
- 31
- Related Works
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- OpenAlex ID
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Raw OpenAlex JSON
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https://openalex.org/W3092375847Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1111/ene.14583Digital Object Identifier
- Title
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Value of treatment by comprehensive stroke services for the reduction of critical gaps in acute stroke care in EuropeWork title
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reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
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2020Year of publication
- Publication date
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2020-10-12Full publication date if available
- Authors
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Alastair J.S. Webb, Ana Catarina Fonseca, Eivind Berge, Gary Randall, Franz Fazekas, Bo Norrving, Emilia Nivelle, Vincent Thijs, Geert VanhoorenList of authors in order
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https://doi.org/10.1111/ene.14583Publisher landing page
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ene.14583Direct link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ene.14583Direct OA link when available
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Medicine, Stroke (engine), Quality-adjusted life year, European union, Cost–benefit analysis, Cost effectiveness, Intensive care medicine, Risk analysis (engineering), Ecology, Economic policy, Engineering, Biology, Business, Mechanical engineeringTop concepts (fields/topics) attached by OpenAlex
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7Total citation count in OpenAlex
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2025: 2, 2024: 1, 2022: 2, 2021: 1, 2020: 1Per-year citation counts (last 5 years)
- References (count)
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31Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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