The cost-effectiveness of stroke rehabilitation care: a systematic review of randomized controlled trails studies
Yuehua Liu, Zhipeng Wang, Haimei Qi
Published 2018-06-14
Cite as Chin J Geriatr, 2018, 37(6): 702-706. DOI: 10.3760/cma.j.issn.0254-9026.2018.06.023
Abstract
ObjectiveTo perform a systematic review of the literature on the cost-effectiveness of stroke rehabilitation care, and to provide evidence for medical insurance payment and clinical decision making on stroke rehabilitation care.
MethodsWe included published randomized controlled trails(RCTs)which compared rehabilitation care(RC)and usual care(UC)on stroke, and summarized clinical outcome, resource use, costs, and other indexes as outcomes of interest.
ResultsAmong included eight RCT studies, the results of four models of stroke care were found as following.(1)Four studies involving early supported discharge(ESD)showed lower costs in rehabilitation care, but similar(n=3)or better(n=1)clinical outcome.(2)Two studies involving home-based rehabilitation showed similar costs in one and lower costs in the other, with no difference in clinical outcome between two trials.(3)One study involving stroke unit care showed higher costs and better clinical outcome.(4)One trial involving integration stroke service was associated with lower costs, but no difference in the effectiveness.
ConclusionsFor patients with stroke, rehabilitation care leads to significant improvements on cost-effectiveness.Promoting the clinical use of rehabilitation care will bring about clinical benefits, increase the efficiency of medical resources use, and improve patient′s quality of life.
Key words:
Stroke; Rehabilitation; Cost-benefit analysis
Contributor Information
Yuehua Liu
China National Health Development Research Center, Beijing 100084, China
Zhipeng Wang
Tsinghua University Department of Hospital Management, Shenzhen 518057, China
Haimei Qi
Department of Geriatric Medicine, Beijing Hospital, Beijing 100730, China