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Verfasst von:Rink, Johann [VerfasserIn]   i
 Froelich, Matthias F. [VerfasserIn]   i
 Nour, May [VerfasserIn]   i
 Saver, Jeffrey L [VerfasserIn]   i
 Szabo, Kristina [VerfasserIn]   i
 Hoyer, Carolin [VerfasserIn]   i
 Fassbender, Klaus C. [VerfasserIn]   i
 Schönberg, Stefan [VerfasserIn]   i
 Tollens, Fabian [VerfasserIn]   i
Titel:Lifetime economic potential of mobile stroke units in acute stroke care
Titelzusatz:a model-based analysis of the drivers of cost-effectiveness
Verf.angabe:Johann S Rink, Matthias F Froelich, May Nour, Jeffrey L Saver, Kristina Szabo, Carolin Hoyer, Klaus C Fassbender, Stefan O Schoenberg, and Fabian Tollens
Jahr:2022
Umfang:10 S.
Fussnoten:Ahead of print, online erstmals veröffentlicht: 9. Dezember 2022 ; Gesehen am 04.06.2024
Titel Quelle:Enthalten in: Journal of telemedicine and telecare
Ort Quelle:London : Sage, 1995
Jahr Quelle:2024
Band/Heft Quelle:30(2024), 8, Seite 1335-1344
ISSN Quelle:1758-1109
Abstract:Background and purpose - To simulate patient-level costs, analyze the economic potential of telemedicine-based mobile stroke units for acute prehospital stroke care, and identify major determinants of cost-effectiveness, based on two recent prospective trials from the United States and Germany. - Methods - A Markov decision model was developed to simulate lifetime costs and outcomes of mobile stroke unit. The model compares diagnostic and therapeutic pathways of ischemic stroke, hemorrhagic stroke, and stroke mimic patients by conventional care or by mobile stroke units. The treatment outcomes were derived from the B_PROUD and the BEST-mobile stroke unit trials and further input parameters were derived from recent literature. Uncertainty was addressed by deterministic and probabilistic sensitivity analyses. A lifetime horizon based on the US healthcare system was adopted to evaluate different cost thresholds for mobile stroke unit and the resulting cost-effectiveness. Willingness-to-pay thresholds were set at 1x and 3x gross domestic product per capita, as recommended by the World Health Organization. - Results - In the base case scenario, mobile stroke unit care yielded an incremental gain of 0.591 quality-adjusted life years per dispatch. Mobile stroke unit was highly cost-effective up to a maximum average cost of 43,067 US dollars per patient. Sensitivity analyses revealed that MSU cost-effectiveness is mainly affected by reduction of long-term disability costs. Also, among other parameters, the rate of stroke mimics patients diagnosed by MSU plays an important role. - Conclusion - This study demonstrated that mobile stroke unit can possibly be operated on an excellent level of cost-effectiveness in urban areas in North America with number of stroke mimic patients and long-term stroke survivor costs as major determinants of lifetime cost-effectiveness.
DOI:doi:10.1177/1357633X221140951
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1177/1357633X221140951
 Volltext: https://journals.sagepub.com/doi/10.1177/1357633X221140951
 DOI: https://doi.org/10.1177/1357633X221140951
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1890578207
Verknüpfungen:→ Zeitschrift

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