PMID: 20645669Jul 22, 2010Paper

Cost analysis review of stroke centers, telestroke, and rt-PA

The American Journal of Managed Care
Bart M DemaerschalkGrace Leung

Abstract

To conduct a systematic literature review analyzing cost-effectiveness or cost savings associated with use of recombinant tissue plasminogen activator (rt-PA), stroke centers, and telemedicine programs for acute ischemic stroke. A literature search was conducted of the PubMed/MEDLINE and Ovid/EMBASE databases from January 1, 1995, to August 30, 2008, limited to English-language articles and using the search terms [stroke and cost and telemedicine] or [stroke and cost and alteplase] or [stroke and cost and tissue plasminogen activator] or [stroke and cost and rt-PA] or [stroke center and cost] or [stroke unit and cost]. Abstracts were reviewed, and inclusion/exclusion criteria were used to select studies. The analysis was limited to studies addressing costs or cost-effectiveness of the interventions in the United States. This search identified 748 abstracts, of which 24 were included. Among these 24 studies were 2 cost-effectiveness, 8 cost-savings, and 4 cost-benefit analyses. All discussed some aspect of practice economics. The primary cost-effectiveness data available for rt-PA use demonstrated increased hospitalization costs but long-term cost savings due to decreased nursing home and rehabilitation costs. No cost-effectiven...Continue Reading

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