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• W2326471878 abstract "Objective: To assess the cost-effectiveness of a telestroke network in the management of acute ischemic stroke (AIS) from three perspectives: the network, hub, and spoke. Background A hub-and-spoke telestroke network is an effective way to extend quality emergency stroke care to remote hospitals and improve patient outcomes. The costs of these networks to the participating hospitals must be considered. Design/Methods: A decision analytic model was developed to compare cost and effectiveness with and without a telestroke network over a 5-year time horizon. The model considered changes in rates of teleconsultations, intravenous (IV) thrombolysis, endovascular stroke therapies, and spoke-to-hub transfers with and without the network. These inputs were estimated using data from Georgia Health Sciences University and Mayo Clinic telestroke networks. Costs included telemedicine set-up and maintenance costs, treatment costs, and reimbursement for AIS. Effectiveness was defined as discharges to home. Incremental effectiveness was assumed to result only from the increased number of patients treated with IV thrombolysis and/or endovascular stroke therapies. One-way sensitivity analyses were conducted. Results: Compared with no network, a network model with 1 hub and 7 spokes resulted in 45 more patients treated with IV thrombolysis and 20 more with endovascular stroke therapies per year, leading to 5.49 more home discharges per 1000 AIS patients. Across a span of transfer rates from 0% to 100%, incremental costs ranged from -$556,000 to -$6000 for the network, $1,485,000 to -$3,428,000 for the hub, and from -$292,000 to $489,000 for each spoke, with negative costs reflecting savings. Results were sensitive to rates of endovascular stroke therapies and transfers. Conclusions: In most scenarios, a telestroke network costs less and is more effective than no network from the network perspective. With increasing transfer rates, the hub experiences greater cost savings while spokes bear higher costs. Supported by: Genentech, Inc. Disclosure: Dr. Switzer has nothing to disclose. Dr. Demaerschalk has received personal compensation for activities with Genentech and Otsuka. Dr. Xie has received personal compensation for activities with Analysis Group, Inc. as an employee. Mr. Fan has received personal compensation for activities with Analysis Group, Inc., as an employee. Ms. Villa has received personal compensation for activites with Genentech, Inc. as an employee. Dr. Wu has received personal compensation for activities with Analysis Group, Inc. as an employee." @default.
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• W2326471878 date "2012-04-22" @default.
• W2326471878 modified "2023-09-26" @default.
• W2326471878 title "Cost-Effectiveness of Hub-and-Spoke Telestroke Networks for the Management of Acute Ischemic Stroke (P05.243)" @default.
• W2326471878 doi "https://doi.org/10.1212/wnl.78.1_meetingabstracts.p05.243" @default.
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