PMID: 9425462Jan 13, 1998Paper

The uptake and costs of guidelines for stroke in a district of southern England

Journal of Epidemiology and Community Health
C D WolfeR Beech

Abstract

To assess the impact of guidelines for stroke management on the utilisation of services by patients and the cost consequences of implementation. Prospective audit. District health authority in southern England. A total of 468 live non-comatose stroke patients registered between November 1991 and May 1993. A comparison between the three, six month periods for investigations performed and rehabilitation received and their associated costs. The appropriateness of the use of investigations improved over time to between 88 and 92% except for computed tomography (CT) (24%). Younger, more severely impaired patients in a medical bed were more likely to have CT. Overall levels of rehabilitation were low. There was no change in use of physiotherapy (61% to 63%), a significant increase in occupational therapy (26% to 39%) and a non significant change in speech therapy (34% to 25%) over time. Guideline introduction caused a modest 23 Pounds increase in costs per patient in the 2nd six months and 41 Pounds in the 3rd six months but this sum could rise to 430 Pounds per patient if full implementation of the guidelines occurred which is still only around 13% of the costs of nursing care while in hospital. This 18 month aduit shows only modest...Continue Reading

References

Nov 1, 1990·Stroke; a Journal of Cerebral Circulation·K A SotaniemiV V Myllylä
Oct 1, 1995·Stroke; a Journal of Cerebral Circulation·L BergmanJ D Habbema
Aug 14, 1993·Lancet·P LanghorneK Howie
Dec 1, 1993·Stroke; a Journal of Cerebral Circulation·I R Odderson, B S McKenna
Apr 1, 1993·Journal of Epidemiology and Community Health·C D WolfeP G Burney
Nov 1, 1996·Stroke; a Journal of Cerebral Circulation·R BeechC Wolfe
Feb 7, 1994·Quality in Health Care : QHC·J M Grimshaw, I T Russell
Nov 4, 1995·Quality in Health Care : QHC·C D Mansfield
Nov 4, 1995·Quality in Health Care : QHC·M EmbertonH B Develin
Apr 1, 1990·The International Journal of Health Planning and Management·R Beech, J Larkinson

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Citations

Jun 11, 2004·Journal of Evaluation in Clinical Practice·Trudy Van Der WeijdenMartien Limburg
Dec 26, 2008·Stroke; a Journal of Cerebral Circulation·Ramon Luengo-FernandezPeter M Rothwell
Jun 9, 2005·The Annals of Pharmacotherapy·Inka I PuumalainenMarja S Airaksinen
Nov 5, 2003·The Journal of Behavioral Health Services & Research·Haider SaeedPhilip Burge
Sep 28, 2004·International Journal of Technology Assessment in Health Care·Ola GhatnekarAndreas Terént

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