Economic evaluation of the Melbourne Mobile Stroke Unit.

International Journal of Stroke : Official Journal of the International Stroke Society
Joosup KimDominique A Cadilhac

Abstract

The Melbourne Mobile Stroke Unit (MSU) is the first Australian service to provide prehospital acute stroke treatment, including thrombolysis and facilitated triage for endovascular thrombectomy. To estimate the cost-effectiveness of the MSU during the first full year of operation compared with standard ambulance and hospital stroke care pathways (standard care). The costs and benefits of the Melbourne MSU were estimated using an economic simulation model. Operational costs and service utilization data were obtained from the MSU financial and patient tracking reports. The health benefits were estimated as disability-adjusted life years (DALYs) avoided using local data on reperfusion therapy and estimates from the published literature on their effectiveness. Costs were presented in Australian dollars. The robustness of results was assessed using multivariable (model inputs varied simultaneously: 10,000 Monte Carlo iterations) and various one-way sensitivity analyses. In 2018, the MSU was dispatched to 1244 patients during 200 days of operation. Overall, 167 patients were diagnosed with acute ischemic stroke, and 58 received thrombolysis, endovascular thrombectomy, or both. We estimated 27.94 DALYs avoided with earlier access to e...Continue Reading

References

Feb 6, 2010·Stroke; a Journal of Cerebral Circulation·Keun-Sik Hong, Jeffrey L Saver
Jun 12, 2010·International Journal of Stroke : Official Journal of the International Stroke Society·Dominique A CadilhacGeoffrey A Donnan
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Oct 29, 2015·Stroke; a Journal of Cerebral Circulation·Ritvij BowryJames C Grotta
Feb 24, 2017·Lancet Neurology·Klaus FassbenderJeffrey L Saver
Apr 30, 2017·Neurology·Atte MeretojaLeonid Churilov
May 18, 2017·Stroke; a Journal of Cerebral Circulation·Felix C NgPhilip M Choi
Jun 15, 2017·International Journal of Stroke : Official Journal of the International Stroke Society·Jose-Miguel YamalJames C Grotta
Jul 19, 2017·Stroke; a Journal of Cerebral Circulation·Laura K SevickFiona Clement
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Jul 18, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Henry ZhaoStephen M Davis
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May 9, 2019·The New England Journal of Medicine·Henry MaUNKNOWN EXTEND Investigators
Mar 3, 2020·Frontiers in Neurology·Andrew P ReimerBelinda L Udeh

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Citations

Sep 9, 2021·The New England Journal of Medicine·James C GrottaRitvij Bowry
Oct 13, 2021·Journal of Telemedicine and Telecare·Stephen W EnglishBart M Demaerschalk
Nov 21, 2021·Current Opinion in Neurology·Martin Ebinger, Heinrich J Audebert
Feb 8, 2022·Current Neurology and Neuroscience Reports·Praveen HariharanAlexandra L Czap

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