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Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective

The purpose of this prospective study was to determine whether the cost and cost-effectiveness of early rehabilitation after stroke are associated with the degree of initial disability. The data for cost calculations were collected by the bottom-up (micro-costing) method alongside the standard inpat...

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Autores principales: Angerova, Yvona, Marsalek, Pavel, Chmelova, Irina, Gueye, Tereza, Uherek, Stepan, Briza, Jan, Bartak, Miroslav, Rogalewicz, Vladimir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643793/
https://www.ncbi.nlm.nih.gov/pubmed/32991353
http://dx.doi.org/10.1097/MRR.0000000000000440
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author Angerova, Yvona
Marsalek, Pavel
Chmelova, Irina
Gueye, Tereza
Uherek, Stepan
Briza, Jan
Bartak, Miroslav
Rogalewicz, Vladimir
author_facet Angerova, Yvona
Marsalek, Pavel
Chmelova, Irina
Gueye, Tereza
Uherek, Stepan
Briza, Jan
Bartak, Miroslav
Rogalewicz, Vladimir
author_sort Angerova, Yvona
collection PubMed
description The purpose of this prospective study was to determine whether the cost and cost-effectiveness of early rehabilitation after stroke are associated with the degree of initial disability. The data for cost calculations were collected by the bottom-up (micro-costing) method alongside the standard inpatient care. The total sample included 87 patients who were transferred from acute care to early rehabilitation unit of three participating stroke centers at the median time poststroke of 11 days (range 4–69 days). The study was pragmatic so that all hospitals followed their standard therapeutic procedures. For each patient, the staff recorded each procedure and the associated time over the hospital stay. The cost and cost-effectiveness were compared between four disability categories. The average cost of the entire hospitalization was CZK 114 489 (EUR 4348) with the daily average of CZK 5103 (EUR 194). The cost was 2.4 times higher for the immobile category (CZK/EU: 167 530/6363) than the self-sufficient category (CZK/EUR: 68 825/2614), and the main driver of the increase was the cost of nursing. The motor status had a much greater influence than cognitive status. We conclude that the cost and cost-effectiveness of early rehabilitation after stroke are positively associated with the degree of the motor but not cognitive disability. To justify the cost of rehabilitation and monitor its effectiveness, it is recommended to systematically record the elements of care provided and perform functional assessments on admission and discharge.
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spelling pubmed-76437932020-11-12 Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective Angerova, Yvona Marsalek, Pavel Chmelova, Irina Gueye, Tereza Uherek, Stepan Briza, Jan Bartak, Miroslav Rogalewicz, Vladimir Int J Rehabil Res Original Articles The purpose of this prospective study was to determine whether the cost and cost-effectiveness of early rehabilitation after stroke are associated with the degree of initial disability. The data for cost calculations were collected by the bottom-up (micro-costing) method alongside the standard inpatient care. The total sample included 87 patients who were transferred from acute care to early rehabilitation unit of three participating stroke centers at the median time poststroke of 11 days (range 4–69 days). The study was pragmatic so that all hospitals followed their standard therapeutic procedures. For each patient, the staff recorded each procedure and the associated time over the hospital stay. The cost and cost-effectiveness were compared between four disability categories. The average cost of the entire hospitalization was CZK 114 489 (EUR 4348) with the daily average of CZK 5103 (EUR 194). The cost was 2.4 times higher for the immobile category (CZK/EU: 167 530/6363) than the self-sufficient category (CZK/EUR: 68 825/2614), and the main driver of the increase was the cost of nursing. The motor status had a much greater influence than cognitive status. We conclude that the cost and cost-effectiveness of early rehabilitation after stroke are positively associated with the degree of the motor but not cognitive disability. To justify the cost of rehabilitation and monitor its effectiveness, it is recommended to systematically record the elements of care provided and perform functional assessments on admission and discharge. Lippincott Williams & Wilkins 2020-09-24 2020-12 /pmc/articles/PMC7643793/ /pubmed/32991353 http://dx.doi.org/10.1097/MRR.0000000000000440 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Articles
Angerova, Yvona
Marsalek, Pavel
Chmelova, Irina
Gueye, Tereza
Uherek, Stepan
Briza, Jan
Bartak, Miroslav
Rogalewicz, Vladimir
Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective
title Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective
title_full Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective
title_fullStr Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective
title_full_unstemmed Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective
title_short Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective
title_sort cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the czech republic perspective
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643793/
https://www.ncbi.nlm.nih.gov/pubmed/32991353
http://dx.doi.org/10.1097/MRR.0000000000000440
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