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A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change.

ABSTRACT: BACKGROUND:Stroke is a significant burden in Saudi Arabia and the Saudi Ministry of Health's stroke committee has identified an urgent need to improve care. AIM:The purpose of this study was to undertake a health-economic analysis to quantify the impact of developing stroke care in the country. METHODS:An economic model was developed to assess the costs and clinical outcomes associated with an ischemic stroke care development program compared with current stroke care. Based on Saudi epidemiological data, cohorts of ischemic stroke patients enter the model each year for the first 10 years based on increasing incidence. Four treatment options were modeled including reperfusion and non-reperfusion treatments. The development scenario estimates the impact of gradually increasing uptake of more effective treatments over 10 years. Changes in the stroke care organization are considered along with resources required to increase capacity, allowing more patients to be admitted to stroke hospitals and access effective treatments. RESULTS:The stroke care development program is associated with an increase in functionally independent patients and a decrease in disabling strokes compared with current stroke care. Additionally, the development program is associated with estimated cost savings of $602 million over 15 years ($255 million direct costs, $348 million indirect costs). CONCLUSIONS:The model predicts that the stroke care development program is associated with improved patient outcomes and lower overall costs compared with the current stroke care program.

SUBMITTER: Al-Senani F

PROVIDER: S-EPMC6823921 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change.

Al-Senani Fahmi F Al-Johani Mohammed M Salawati Mohammad M ElSheikh Souda S AlQahtani Maha M Muthana Jamal J AlZahrani Saeed S Shore Judith J Taylor Matthew M Ravest Valeska S VS Eggington Simon S Cuche Matthieu M Davies Heather H Lobotesis Kyriakos K Saver Jeffrey L JL

International journal of stroke : official journal of the International Stroke Society 20190523 8

<h4>Background</h4>Stroke is a significant burden in Saudi Arabia and the Saudi Ministry of Health's stroke committee has identified an urgent need to improve care.<h4>Aim</h4>The purpose of this study was to undertake a health-economic analysis to quantify the impact of developing stroke care in the country.<h4>Methods</h4>An economic model was developed to assess the costs and clinical outcomes associated with an ischemic stroke care development program compared with current stroke care. Based ...[more]

PMID: 31122171

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Project description:BackgroundIschaemic stroke care requires a co-ordinated multi-disciplinary approach to optimise patient outcomes. Current care provision in Saudi Arabia is below international recommendations, and with increasing patient numbers, variable access to new therapies, and sub-optimal co-ordination of staff, the Kingdom's Ministry of Health has prioritised strategies to develop stroke care. Our objective was to use local epidemiological data to predict stroke incidence and to combine this with international staffing recommendations to estimate future staff requirements and their costs over a 10-year period.MethodsWe researched existing stroke services and staff availability within Saudi Arabia to establish current provision, undertook epidemiological modelling to predict stroke incidence, and used international staffing recommendations for acute and rehabilitation services to develop a care pathway to provide state-of-the-art stroke services. This information was used to determine the additional staff requirements, and their costs, across the Kingdom.ResultsOur research concluded that current staff numbers and services are inadequate to cope with the projected increase in the number of stroke cases. In order to provide acute and rehabilitation services which use the latest technologies, re-organisation of existing staff and services would be required, together with significant investment in new staff across several disciplines. An estimated additional 43.8 full-time equivalent stroke neurologists would be required, plus 53.5 full-time equivalent interventional neuroradiologists in addition to expansion of occupational therapy and psychology services. The total cost of additional staff over 10 years was estimated to be 862 390 778 Saudi Riyals ($229 970 874).ConclusionsProviding high-quality care for ischaemic stroke patients would involve significant investment in new staff in Saudi Arabia. Further research is required on the applicability of international staffing ratios to countries where there is a significant workforce gap. Nevertheless, this analysis provides a framework to inform stroke care planning and can be adapted to other regions or countries.

Dataset Information

A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change.

Publications

A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change.

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