Assessment of Rehabilitation Technologies in Stroke: <i>Outcomes and Costs</i>

Hass, Ursula; Persson, Jan; Brodin, Hå̊kan; Fredén-Karlsson, Ingrid; Olsson, Jan‐Edvin; Berg, I.J.

doi:10.1017/s0266462300006863

Cited by 15 publications

(20 citation statements)

References 19 publications

(10 reference statements)

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“…A possibly better stroke unit effect for patients with severe stroke corresponds with the findings of other studies, which have shown that the severity of stroke influences the length of hospital stay 6,21 and the pattern of total utilization of both hospital and nonhospital care. 7,17 Furthermore, Stroke Unit Trialists' Collaborations' meta-analytic data indicate a more marked effect of stroke unit care for patients with severe stroke versus mild stroke. 44 In conclusion, the present study showed that the total costs the first year did not differ significantly between the treatment groups.…”

Section: Discussionmentioning

confidence: 99%

Resource Utilization and Costs of Stroke Unit Care Integrated in a Care Continuum: A 1-Year Controlled, Prospective, Randomized Study in Elderly Patients

Claesson

Gosman‐Hedström

Johannesson

et al. 2000

Stroke

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Background and Purpose-The aim of the present study was to examine resource utilization during a 12-month period after acute stroke in elderly patients randomized to care in an acute stroke unit integrated with a care continuum compared with conventional care in general medical wards. A secondary aim was to describe costs related to the severity of stroke. Methods-Two hundred forty-nine consecutive patients aged Ն70 years with acute stroke within 7 days before admission, living in their own homes in Göteborg, Sweden, without recognized need of care were randomized to 2 groups: 166 patients were assigned to nonintensive stroke unit care with a care continuum, and 83 patients were assigned to conventional care. There was no difference in mortality or the proportion of patients living at home after 1 year. Main outcomes were costs from inpatient care, outpatient care, and informal care. Results-Mean annual cost per patient was 170 000 Swedish crowns (SEK) (equivalent to $25 373) and 191 000 SEK ($28 507) in the stroke unit and the general medical ward groups, respectively (PϭNS). Seventy percent of the total cost was for inpatient care, and 30% was for outpatient and informal care. For patients with mild, moderate, and severe stroke, the mean annual costs per patient were 107 000 SEK ($15 970), 263 000 SEK ($39 254), and 220 000 SEK ($32 836), respectively (PϽ0.001). There was no statistical difference in age or nonstroke diagnosis. Conclusions-The total costs the first year did not differ significantly between the treatment groups in this prospective study. The total annual cost per patient showed a very large variation, which was related to stroke severity at onset and not to age or nonstroke diagnoses. Costs other than those for hospital care constituted a substantial fraction of total costs and must be taken into account when organizing the management of stroke patients. The high variability in costs necessitates a larger study to assess long-term cost effectiveness.

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Section: Discussionmentioning

confidence: 99%

Resource Utilization and Costs of Stroke Unit Care Integrated in a Care Continuum: A 1-Year Controlled, Prospective, Randomized Study in Elderly Patients

Claesson

Gosman‐Hedström

Johannesson

et al. 2000

Stroke

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“…Assistive technologies are used frequently by stroke patients (about So%, see e.g., (4)) in order to reduce or compensate for the lost functions. Patients who use assistive devices one year after suffering stroke perceive and rate their life situation as being considerably more impaired compared with those without assistive devices, even when adjustments for differences in functional ability are made (5). Lawrence & Christie (6) also showed that patients' lives are mainly influenced by their own response to their disabilities and not by the physical disabilities in themselves.…”

Section: Introductionmentioning

confidence: 99%

“…The resources spent on assistive devices during the first year after stroke are about 1% of the total cost of the rehabilitation programme (5,4). There are few studies on costs for assistive devices, but the additional costs incurred in the selection process have been estimated as being as high as the cost of the devices themselves (7).…”

Section: Introductionmentioning

confidence: 99%

Assistive Technologies in Stroke Rehabilitation from a User Perspective

Hass

Fredén-Karlsson²,

Persson

1996

Scandinavian Caring Sciences

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The purpose of the study was to provide knowledge, from a user perspective, about the selection process for assistive devices. Thirty-eight persons who had suffered stroke were interviewed about their assistive devices, approximately one year after stroke. It was found that the patients had little influence on the choice of assistive devices and that the maintenance and follow-up routines varied among patients. In some cases follow-up was not done at all. Despite these deficits, the patients used their assistive devices as intended.

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“…The higher prevalence of hypertension found in the elderly [6] explains this observation, given the higher risk of CV complications, including heart failure, in the older population compared with younger hypertensives. Antihypertensive treatment [46,61,66] has been shown to reduce this risk in the elderly. The observation that 70% of the excess costs could be attributed to the minority of patients with BP >160/95 mmHg is not surprising, as the frequency of CHF and stroke increases greatly as BP exceeds 160/95 mmHg [13].…”

Section: Discussionmentioning

confidence: 99%

“…Costs were primarily obtained from government sources and published studies. Where published data was not available, costs were estimated using the product of OECD average length of stay (ALOS) data for the speci c CV event and the local per diem costs [18,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. …”

Section: Risk Of CV Eventsmentioning

confidence: 99%