Posts Tagged Economic
[A Systematic Review] The Clinical, Quality of Life and Economic Outcomes of Inpatient Rehabilitation – Full Text PDF
Objective: To systematically review the clinical, functional and economic benefits of Inpatient Rehabilitation for the most common disorders of the nervous system: stroke, spinal cord injury, and multiple sclerosis.
Methodology: PubMed, Embase, Scopus, CEA Registry, and NHS EED databases were searched using combinations of three sets of keywords using various terms for rehabilitation, benefits, and treatments. The outcomes considered included measures of independence in activities of daily living (ADL), motor function, disability, handicap,
gait velocity, quality of life, and economics. Following the initial literature search, the abstracts and full texts of the identified studies were reviewed and assessed for inclusion by two independent researchers based on pre-determined criteria. The data of selected studies were extracted into a data extraction form and consequently were synthesized.
Results: Forty-six articles met the inclusion criteria. Particularly, 21 studies evaluated inpatient rehabilitation after (or following) stroke, 15 studies evaluated inpatient rehabilitation after SCI, and seven studies evaluated inpatient rehabilitation for MS patients. The remaining three studies referred to mixed patient population. The majority of studies indicated that inpatient rehabilitation can provide clinical and functional benefits for all patient groups under consideration. Moreover, economic evaluations indicate that rehabilitation may be cost saving or cost-effective in certain patient groups such as those with fractures and stroke.
Conclusion: The results of the present review demonstrate that inpatient rehabilitation may deliver significant health and economic benefits for patients suffering from stroke, spinal cord injury, or multiple sclerosis and for health systems. Further research is needed to improve the consistency and robustness of the available evidence.
Stroke is often a severe and debilitating event that requires ongoing rehabilitation. The Community Stroke Rehabilitation Teams (CSRT) offer home-based stroke rehabilitation to individuals for whom further therapy is unavailable or inaccessible.
The objective of this study was to evaluate the cost-effectiveness of the CSRT program compared with a ‘No Therapy’ cohort. Data were collected on CSRT clients from January 2012 to February 2013. Comparator data were derived from a study of stroke survivors with limited access to rehabilitation.
Literature derived values were used to inform a long-term projection. Using Markov modelling, we projected the model for 35 years. One-way, two-way, and Probabilistic Sensitivity Analyses were performed. Results demonstrate that the CSRT has a Net Monetary Benefit of $43,115 over No Therapy, and is both less costly and more effective. The CSRT model of care should be considered when evaluating potential stroke rehabilitation delivery methods.