Conflicts of interest: None declared.
Processes of early stroke care and hospital costs
Article first published online: 19 DEC 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 9, Issue 6, pages 777–782, August 2014
How to Cite
Svendsen, M. L., Ehlers, L. H., Hundborg, H. H., Ingeman, A. and Johnsen, S. P. (2014), Processes of early stroke care and hospital costs. International Journal of Stroke, 9: 777–782. doi: 10.1111/ijs.12221
Funding: The study was funded by the Research Foundation of Health Science in The Central Denmark Region.
The study was presented at the 8th World Stroke Congress in Brazil, 2012.
- Issue published online: 17 JUL 2014
- Article first published online: 19 DEC 2013
- Research Foundation of Health Science in The Central Denmark Region
- hospital costs;
- length of stay;
- quality indicators (health care);
- quality of health care;
The relationship between processes of early stroke care and hospital costs remains unclear.
We therefore examined the association in a population-based cohort study.
We identified 5909 stroke patients who were admitted to stroke units in a Danish county between 2005 and 2010. The examined recommended processes of care included early admission to a stroke unit, early initiation of antiplatelet or anticoagulant therapy, early computed tomography/magnetic resonance imaging (CT/MRI) scan, early physiotherapy and occupational therapy, early assessment of nutritional risk, constipation risk and of swallowing function, early mobilization, early catheterization, and early thromboembolism prophylaxis. Hospital costs were assessed for each patient based on the number of days spent in different in-hospital facilities using local hospital charges.
The mean costs of hospitalization were $23 352 (standard deviation 27 827). The relationship between receiving more relevant processes of early stroke care and lower hospital costs followed a dose–response relationship. The adjusted costs were $24 566 (95% confidence interval 19 364–29 769) lower for patients who received 75–100% of the relevant processes of care compared with patients receiving 0–24%. All processes of care were associated with potential cost savings, except for early catheterization and early thromboembolism prophylaxis.
Early care in agreement with key guidelines recommendations for the management of patients with stroke may be associated with hospital savings.