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A comparison of the cost-effectiveness of stroke care provided in London and Copenhagen

Grieve, Richard, Porsdal, Vibeke, Hutton, John and Wolfe, Charles (2000) A comparison of the cost-effectiveness of stroke care provided in London and Copenhagen. International Journal of Technology Assessment in Health Care, 16 (2). pp. 684-695. ISSN 0266-4623

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Identification Number: 10.1017/S0266462300101242

Abstract

Objectives: This study compared the relative cost-effectiveness of stroke care provided in London and Copenhagen. Methods: Hospitalized stroke patients at centers in London (1995–96) and Copenhagen (1994–95) were included. Each patient's use of hospital and community health services was recorded for 1 year after stroke. Center-specific unit costs were collected and converted into dollars using the Purchasing Power Parity Index. An incremental cost-effectiveness ratio (ICER) was calculated comparing a Copenhagen model of stroke care to a London model, using regression analysis to adjust for case-mix differences. Results: A total of 625 patients (297 in Copenhagen, 328 in London) were included in the analysis. Most patients in London (85%) wereadmitted to general medical wards, with 26% subsequently transferred to a stroke unit. In Copenhagen, 57% of patients were directly admitted to a stroke or neurology unit, with 23% then transferred to a separate rehabilitation hospital. The average length of total hospital stay was 11 days longer in Copenhagen. Patients in Copenhagen were less likely to die than those in London; for patients with cerebral infarction the hazard ratio after case-mix adjustment was 0.53 (95% CI from 0.35 to 0.80). However, a lower proportion of patients with hemorrhagic stroke died in London. The ICER of using the Copenhagen compared with the London model of care ranged from 21,579to37,444 per life-year gained for patients with cerebral infarctions. Conclusions: The ICERs of the Copenhagen compared with the London model of care were within a range generally regarded as cost-effective.

Item Type: Article
Official URL: http://journals.cambridge.org/action/displayJourna...
Additional Information: © 2000 Cambridge University Press
Divisions: LSE
Subjects: R Medicine > R Medicine (General)
Date Deposited: 05 Dec 2008 15:44
Last Modified: 20 Jul 2019 00:28
URI: http://eprints.lse.ac.uk/id/eprint/6979

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