|
In the first study of its kind, researchers have found that using "telestroke," two-way audio-video telemedicine to deliver stroke care, appears to be cost-effective for rural hospitals that don't have an around-the-clock neurologist on staff (Neurology,Sept. 14, 2011).
"In an era of spiraling health care costs, our findings give critical information to medical policy-makers," said Jennifer Majersik, MD, of the University of Utah School of Medicine in Salt Lake City. "If barriers to using telestroke - such as low reimbursement rates and high equipment costs - are improved, telestroke has the potential to greatly diminish the striking disparity in stroke care for rural America."
Researchers used existing data from previous telestroke studies as well as data from large multi-hospital telestroke network databases at the University of Utah Hospitals and Clinics in Salt Lake City and Mayo Clinic in Phoenix.
They calculated cost-effectiveness by comparing the costs and quality-adjusted life years of patients treated by telestroke to those treated by usual care, such as a rural emergency department without telestroke or a stroke expert available.
Quality-adjusted life year is a measure of disease burden based on the number of years of life that would be added by using telestroke and the quality of life during those years.
The cost of telestroke over a person's lifetime was less than $2,500 per quality-adjusted life year, the study found. The threshold of $50,000 per quality-adjusted life year commonly is cited as the cut-off for cost-effectiveness.
Telestroke also can help with increasing the low number of patients in rural areas receiving tPA, the clot-busting drug that can reduce death and disability from stroke but must be given within the first three to four-and-a-half hours after symptoms begin, Dr. Majersik stated.
"Only 2 to 4 percent of stroke patients receive this treatment, with the lowest percentage in rural areas largely because there aren't enough stroke experts with experience using tPA. Telestroke has the potential to lower this barrier by providing long-distance consultation to rural areas, increasing the expertise and quality of stroke care at rural hospitals."
The study was supported by the National Institutes of Health and the National Cancer Institute.
|