Publication
Stroke rehabilitation pathways during the first year: A cost-effectiveness analysis from a cohort of 460 individuals
| dc.contributor.author | Barbosa, Pedro | |
| dc.contributor.author | Szrek, Helena | |
| dc.contributor.author | Ferreira, Lara Noronha | |
| dc.contributor.author | Cruz, Vítor Tedim | |
| dc.contributor.author | Firmino-Machado, João | |
| dc.date.accessioned | 2024-11-08T11:42:38Z | |
| dc.date.available | 2024-11-08T11:42:38Z | |
| dc.date.issued | 2024-05 | |
| dc.description.abstract | Stroke burden challenges global health, and social and economic policies. Although stroke recovery encompasses a wide range of care, including in-hospital, outpatient, and community-based rehabilitation, there are no published cost-effectiveness studies of integrated post-stroke pathways. To determine the most cost-effective rehabilitation pathway during the first 12 months after a f irst-ever stroke. A cohort of people in the acute phase of a first stroke was followed after hospital discharge; 51 % women, mean (SD) age 74.4 (12.9) years, mean National Institute of Health Stroke Scale score 11.7 (8.5) points, and mode modified Rankin Scale score 3 points. We developed a decision tree model of 9 sequences of rehabilitation care organised in 3 stages (3, 6 and 12 months) through a combination of public, semi-public and private entities, considering both the individual and healthcare service perspectives. Health outcomes were expressed as quality-adjusted life years (QALY) over a 1-year time horizon. Costs included healthcare, social care, and productivity losses. Sensitivity analyses were conducted on model input values. From the individual perspective, pathway 3 (Short-term Inpatient Unit » Community Clinic) was the most cost-effective, followed by pathway 1 (Rehabilitation Centre » Community Clinic). From the healthcare service perspective, pathway 3 was the most cost-effective followed by pathway 7 (Outpatient Hospital » Private Clinic). All other pathways were considered strongly dominated and excluded from the analysis. The total 1-year mean cost ranged between €12104 and €23024 from the individual’s perspective and between €10992 and€31319 fromthe healthcare service perspective. Assuming a willingness-to-pay threshold of one times the national gross domestic product (€20633/QALY), pathway 3 (Short-term Inpatient Unit » Community Clinic) was the most cost-effective strategy from both the individual and healthcare service perspectives. Rehabilitation pathway data contribute to the development of a future integrated care system adapted to different stroke profiles. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Barbosa, P. M., Szrek, H., Ferreira, L. N., Cruz, V. T., & Firmino-Machado, J. (2024). Stroke rehabilitation pathways during the first year: A cost-effectiveness analysis from a cohort of 460 individuals. Annals of Physical and Rehabilitation Medicine, 67(4), 101824. https://doi.org/10.1016/j.rehab.2024.101824 | pt_PT |
| dc.identifier.doi | 10.1016/j.rehab.2024.101824 | pt_PT |
| dc.identifier.eissn | 1877-0655 | |
| dc.identifier.issn | 1877-0657 | |
| dc.identifier.uri | http://hdl.handle.net/10400.22/26346 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.relation.publisherversion | https://www.sciencedirect.com/science/article/pii/S1877065724000083?via%3Dihub | pt_PT |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | pt_PT |
| dc.subject | Pathway | pt_PT |
| dc.subject | Stroke | pt_PT |
| dc.subject | Rehabilitation | pt_PT |
| dc.subject | Outcomes | pt_PT |
| dc.subject | Cost-analysis | pt_PT |
| dc.subject | Health policy | pt_PT |
| dc.title | Stroke rehabilitation pathways during the first year: A cost-effectiveness analysis from a cohort of 460 individuals | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.title | Annals of Physical and Rehabilitation Medicine | pt_PT |
| oaire.citation.volume | 67 (4) | pt_PT |
| person.familyName | Barbosa | |
| person.givenName | Pedro | |
| person.identifier.ciencia-id | 7211-01BC-964D | |
| person.identifier.orcid | 0000-0003-4189-674X | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |
| relation.isAuthorOfPublication | 5bc4be6b-7ce7-4c0a-a4d4-7ac41319ca94 | |
| relation.isAuthorOfPublication.latestForDiscovery | 5bc4be6b-7ce7-4c0a-a4d4-7ac41319ca94 |