Estimating costs and benefits of stroke management: A population-based simulation model
© 2020, © Operational Research Society 2020. The paper demonstrates how a system dynamics approach can support strategic planning of health care services and can in particular help to balance cost-effectiveness considerations with budget impact considerations when assessing a comprehensive package of stroke care interventions in Singapore. A population-level system dynamics model is used to investigate 12 intervention scenarios based on six stroke interventions (a public information campaign, thrombolysis, endovascular therapy, acute stroke unit (ASU), out-of-hospital rehabilitation, and secondary prevention). Primary outcomes included cumulative discounted costs and quality-adjusted life years (QALYs) gained, as well as cumulative net monetary benefit by 2030. All intervention scenarios result in an increase in net monetary benefit by 2030; much of these gains were realized through improved post-acute care. Findings highlight the importance of coordination of care, and affirms the economic value of current stroke interventions.
Bayer, S; Eom, K; Sivapragasam, N; Silva, DAD; Choon, G; Koh, H; Tan, KB; Ansah, JP; Matchar, DB
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