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Estimating costs and benefits of stroke management: a population-based simulation model

Estimating costs and benefits of stroke management: a population-based simulation model
Estimating costs and benefits of stroke management: a population-based simulation model
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.
System dynamics, health systems, stroke
0160-5682
2122-2134
Bayer, Steffen
28979328-d6fa-4eb7-b6de-9ef97f8e8e97
Eom, Kirsten
12312491-1be9-4ee5-b1d4-a455b5316480
Sivapragasam, Nirmali
f77919ee-ad86-4cfd-aec5-242d87141a59
De Silva, Deidre
31dbc737-4ab1-4107-b81f-b66efd823d56
Koh, Gerald Choon-Huat
c0c56cd0-714e-4fc4-9c68-380022a9ec49
Tan, Kelvin Bryan
90c7c5b6-05ea-4818-8f1a-76be434aa59c
Ansah, John P.
48a4f038-3e31-49e5-ba13-4504a73b54ed
Matchar, David B.
d93302f6-c585-4c64-a58d-c6d63264f928
Bayer, Steffen
28979328-d6fa-4eb7-b6de-9ef97f8e8e97
Eom, Kirsten
12312491-1be9-4ee5-b1d4-a455b5316480
Sivapragasam, Nirmali
f77919ee-ad86-4cfd-aec5-242d87141a59
De Silva, Deidre
31dbc737-4ab1-4107-b81f-b66efd823d56
Koh, Gerald Choon-Huat
c0c56cd0-714e-4fc4-9c68-380022a9ec49
Tan, Kelvin Bryan
90c7c5b6-05ea-4818-8f1a-76be434aa59c
Ansah, John P.
48a4f038-3e31-49e5-ba13-4504a73b54ed
Matchar, David B.
d93302f6-c585-4c64-a58d-c6d63264f928

Bayer, Steffen, Eom, Kirsten, Sivapragasam, Nirmali, De Silva, Deidre, Koh, Gerald Choon-Huat, Tan, Kelvin Bryan, Ansah, John P. and Matchar, David B. (2020) Estimating costs and benefits of stroke management: a population-based simulation model. Journal of the Operational Research Society, 72 (9), 2122-2134. (doi:10.1080/01605682.2020.1772018).

Record type: Article

Abstract

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.

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Accepted/In Press date: 17 May 2020
e-pub ahead of print date: 23 June 2020
Keywords: System dynamics, health systems, stroke

Identifiers

Local EPrints ID: 440961
URI: http://eprints.soton.ac.uk/id/eprint/440961
ISSN: 0160-5682
PURE UUID: c038bcc4-66fd-4b34-9949-10f2fccdff35
ORCID for Steffen Bayer: ORCID iD orcid.org/0000-0002-7872-467X

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Date deposited: 26 May 2020 16:31
Last modified: 12 May 2022 04:01

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Contributors

Author: Steffen Bayer ORCID iD
Author: Kirsten Eom
Author: Nirmali Sivapragasam
Author: Deidre De Silva
Author: Gerald Choon-Huat Koh
Author: Kelvin Bryan Tan
Author: John P. Ansah
Author: David B. Matchar

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