London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 469 348 Management and economics Burden of stroke in a large county in Sweden Sickness cost and potential development J. Ferraz-Nunes1 University West, Goteborg, SWEDEN1 Objective: To estimate the economic burden of stroke in a large county with 1.5 million inhabitants in West Sweden and discuss the potential for improvement given different conditions. Materials and methods: Estimation of the economic burden of stroke was done from a societal per-spective with an incidence approach. Data were collected from clinical registries and 3 074 patients were included. In the cost calculations both direct and indirect costs were estimated and were based on costs for 12 months after a first-ever stroke. Estimation of the value of informal care was based on interviews. Results: The present value of total excess costs arising from stroke was €69 million during the first 12 months after the first-ever stroke for a population of 1.5 million. Men consumed more acute care in hospitals, while women consumed more rehabilitation and long-term care provided by munic-ipalities. Younger patients brought a significantly higher burden on the society compared to older patients, due to the loss of productivity and the increased use of resources in health care. The impact of increased inputs in specific activities like secondary prevention and rehabilitation may give rise to increased cost efficient at the margin, but the effect in total cost should not decrease. Conclusions: The results of this cost of illness study are consistent with previous studies, although we have improved the cost calculation process in a number of fields. For the scientific analysis it is of importance to clearly state details in the population such as age and medical status. The result of this study can be used for further development of the methods for economic analyses as well as for analysis of improvements and investments in health care. 349 Management and economics Trends in the cost-effectiveness of Stroke Care E. Urbina-Valdespino1, O. Saka2, C.D.A. Wolfe3, T. Rudd4, A. McGuire5, J. Maervoet6 Deloitte, Diegem, BELGIUM1, King’s College London, London, UNITED KINGDOM2, King’s College London, London, UNITED KINGDOM3, King’s College London, London, UNITED KINGDOM4, London School of Economics, London, UNITED KINGDOM5, Deloitte, Diegem, BELGIUM6 Background Stroke services in many European countries have been subject to changes in the recent years espe-cially with the emergence of stroke units. Yet no study has evaluated the year on year economics of stroke care provision for the purpose of investigating the state of efficiency gains. For this study we have developed a discrete event simulation model to assess the annual average and incremental costs and quality adjusted life years (QALYs) of stroke services between 2006-2011. Incremental cost ef-fectiveness ratios (ICER) comparing each year with the year before were calculated. Methods Data from the South London Stroke Register from 2006 to 2011 were used to populate the health economic model. The parameters included in the analysis were calculated by using cox regression and multivariate regression methods and used as input for the model. The model simulated the stroke care delivery from stroke onset with10-year follow up. Organised Care Index (OCI) was used to assess the improvements in the provision of stroke services and measurement of QALYs. Year-on-year average and incremental cost effectiveness was calculated in order to assess the progression. Results OCI index scores have constantly improved since 2006 with a higher proportion of patients having access to better organised stroke care. The average total costs per patient decreased from £30,745 to £27,086 and quality adjusted life years improved from 2.18 to 3.07 from 2006 till 2011 (p-value for trend < 0.001) indicating a drop in average cost per QALY. Economic evaluation results suggest dominant or very favourable ICER ratios when each year is compared with the year before. Conclusion The reconfigurations to stroke care have provided better value for money over time with constant efficiency gains in stroke services. The use of real world evidence studies such as SLSR is crucial to evaluate the trends and provide guidance to policy makers.
Karger_ESC London_2013
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