Dataset Information

Economic evaluation of nurse-led stroke aftercare addressing long-term psychosocial outcome: a comparison to care-as-usual.

ABSTRACT:

Objective

To examine the cost-effectiveness of nurse-led stroke aftercare addressing psychosocial outcome at 6?months post stroke, compared with care-as-usual.

Design

Economic evaluation within a comparative effectiveness research design.

Setting

Primary care (2016-2017) and community settings (2011-2013) in the Netherlands.

Participants

Persons who suffered from ischaemic or haemorrhagic stroke, or a transient ischaemic attack and were discharged home after visiting the emergency department, hospitalisation or inpatient rehabilitation.

Interventions

Nurse-led stroke aftercare at 6 months post stroke addressing psychosocial functioning by providing screening, psycho-education, emotional support and referral to specialist care when needed. Care-as-usual concerned routine follow-up care including secondary prevention programmes and a consultation with the neurologist at 6 weeks post stroke.

Primary and secondary outcome measures

Main outcome measure of cost-effectiveness was quality-adjusted life years (QALYs) estimated by the quality of life measured by the five-dimensional, three-level EuroQol. Costs were assessed using a cost-questionnaire. Secondary outcomes were mood (Hospital Anxiety and Depression Scale) and social participation (Utrecht Scale for Evaluation of Rehabilitation-Participation) restrictions subscale.

Results

Health outcomes were significantly better in stroke aftercare for QALYs (?=0.05; 95%?CI 0.01 to 0.09) and social participation (?=4.91; 95%?CI 1.89 to 7.93) compared with care-as-usual. Total societal costs were €1208 higher in stroke aftercare than in care-as-usual (95%?CI -€3881 to €6057). Healthcare costs were in total €1208 higher in stroke aftercare than in care-as-usual (95%?CI -€3881 to €6057). Average costs of stroke aftercare were €91 (SD=€3.20) per person. Base case cost-effectiveness analyses showed an incremental cost-effectiveness ratio of €24 679 per QALY gained. Probability of stroke aftercare being cost-effective was 64% on a €50 000 willingness-to-pay level.

Conclusions

Nurse-led stroke aftercare addressing psychosocial functioning showed to be a low-cost intervention and is likely to be a cost-effective addition to care-as-usual. It plays an important role by screening and addressing psychosocial problem, not covered by usual care.

SUBMITTER: Verberne DPJ

PROVIDER: S-EPMC7908908 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Economic evaluation of nurse-led stroke aftercare addressing long-term psychosocial outcome: a comparison to care-as-usual.

Verberne Daan P J DPJ van Mastrigt Ghislaine A P G GAPG Ponds Rudolf W H M RWHM van Heugten Caroline M CM Kroese Mariëlle E A L MEAL

BMJ open 20210225 2

<h4>Objective</h4>To examine the cost-effectiveness of nurse-led stroke aftercare addressing psychosocial outcome at 6 months post stroke, compared with care-as-usual.<h4>Design</h4>Economic evaluation within a comparative effectiveness research design.<h4>Setting</h4>Primary care (2016-2017) and community settings (2011-2013) in the Netherlands.<h4>Participants</h4>Persons who suffered from ischaemic or haemorrhagic stroke, or a transient ischaemic attack and were discharged home after visiting ...[more]

PMID: 33632749

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Dataset Information

Economic evaluation of nurse-led stroke aftercare addressing long-term psychosocial outcome: a comparison to care-as-usual.

Objective

Design

Setting

Participants

Interventions

Primary and secondary outcome measures

Results

Conclusions

Publications

Economic evaluation of nurse-led stroke aftercare addressing long-term psychosocial outcome: a comparison to care-as-usual.

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