TY - JOUR
T1 - Cost-effectiveness of home-based stroke rehabilitation across Europe
T2 - a modelling study
AU - Candio, Paolo
AU - Violato, Mara
AU - Luengo-Fernandez, Ramon
AU - Leal, Jose
PY - 2022/1/15
Y1 - 2022/1/15
N2 - The aim of this study was to explore the cost-effectiveness of home-based versus centre-based rehabilitation in stroke patients across Europe. A Markov model was developed to evaluate the cost-effectiveness of home-based rehabilitation in 32 European countries, compared to centre-based rehabilitation. A cost-utility analysis was conducted from a societal perspective including healthcare, social care and informal care costs, and productivity losses. Health outcomes were expressed as QALYs. Sensitivity analyses were conducted concerning model input values and structural assumptions. Data were obtained from a population-based cohort and previously published studies. Across Europe, over 855,000 patients with stroke would be eligible for rehabilitation in 2017. Europe-wide implementation of home-based rehabilitation was estimated to produce 61,888 additional QALYs (95% CI: 3,609 to 118,679) and cost savings of €237 million (95% CI: -237 to 1,764) and of €352 million (95% CI: -340 to 2,237) in health- and social-care and societal costs, respectively. Under base case assumptions, home-based rehabilitation was found to be highly likely to be cost-effective (>90%), compared to centre-based rehabilitation, in most European countries (29 out of 32). Evidence from this study suggests that a shift from a centre-based to a home-based approach to stroke rehabilitation is likely to be good value for money in most European countries. Further research should be conducted to assess the generalisability of these findings to local settings.
AB - The aim of this study was to explore the cost-effectiveness of home-based versus centre-based rehabilitation in stroke patients across Europe. A Markov model was developed to evaluate the cost-effectiveness of home-based rehabilitation in 32 European countries, compared to centre-based rehabilitation. A cost-utility analysis was conducted from a societal perspective including healthcare, social care and informal care costs, and productivity losses. Health outcomes were expressed as QALYs. Sensitivity analyses were conducted concerning model input values and structural assumptions. Data were obtained from a population-based cohort and previously published studies. Across Europe, over 855,000 patients with stroke would be eligible for rehabilitation in 2017. Europe-wide implementation of home-based rehabilitation was estimated to produce 61,888 additional QALYs (95% CI: 3,609 to 118,679) and cost savings of €237 million (95% CI: -237 to 1,764) and of €352 million (95% CI: -340 to 2,237) in health- and social-care and societal costs, respectively. Under base case assumptions, home-based rehabilitation was found to be highly likely to be cost-effective (>90%), compared to centre-based rehabilitation, in most European countries (29 out of 32). Evidence from this study suggests that a shift from a centre-based to a home-based approach to stroke rehabilitation is likely to be good value for money in most European countries. Further research should be conducted to assess the generalisability of these findings to local settings.
KW - Cost-effectiveness
KW - Decision-making
KW - Europe
KW - Rehabilitation
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85123068320&partnerID=8YFLogxK
U2 - 10.1016/j.healthpol.2022.01.007
DO - 10.1016/j.healthpol.2022.01.007
M3 - Article
SN - 0168-8510
VL - 126
SP - 183
EP - 189
JO - Health Policy
JF - Health Policy
IS - 3
ER -