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[Evaluation of a stroke unit at a university hospital in Chile]
Violeta Díaz T1, Sergio Illanes D, Andrés Reccius M
1Departamento de Neurología y Neurocirugía, Unidad de Patología Cerebro Vascular, Hospital Clínico, Universidad de Chile, Chile. vdias@med.uchile.cl
Insights
A dedicated Stroke Unit in Chile reduced patient hospital stays without significantly increasing costs. This specialized care unit proved effective for managing stroke patients, improving outcomes and resource utilization.
Area of Science:
- Neurology
- Public Health
- Health Economics
Background:
- Stroke is a leading cause of death and hospitalization in Chile.
- High mortality rates underscore the need for effective stroke management strategies.
Purpose of the Study:
- To characterize patients admitted to a general hospital's Stroke Unit.
- To evaluate the costs and benefits associated with operating a Stroke Unit.
Main Methods:
- A retrospective descriptive study utilizing a patient registry.
- Analysis included patient demographics, stroke types (ischemic/hemorrhagic), etiologies, and complications.
- Mean costs per patient and length of stay were calculated.
Main Results:
- 105 stroke patients were admitted to the Stroke Unit in 2003, predominantly with ischemic stroke (83%).
- Common etiologies included thrombosis (41%) and embolism (36%). Hypertension (73%) and diabetes (29.5%) were prevalent comorbidities.
- Mean length of stay in the Stroke Unit was 6.6 days, significantly shorter than the overall hospital stay (9.9 days).
Conclusions:
- The Stroke Unit effectively reduced hospital length of stay.
- The specialized unit did not substantially increase healthcare costs.
- The established inclusion criteria and registry system facilitated effective assessment of the Stroke Unit's performance.
Background:
Stroke is the second specific cause of death in Chile, with a mortality rate of 48.6 per 100.000 inhabitants. It accounts for 6% of all hospitalizations among adults.
Aim:
To study the type of patients hospitalized at a Stroke Unit in a general hospital and the costs and benefits of such unit.
Material And Methods:
A descriptive and retrospective study using a patient registry, developed in Access that included separate sections for ischemic and hemorrhagic stroke. Established diagnostic criteria were used. The mean costs per patient and complications were also calculated.
Results:
During 2003, 425 stroke patients were admitted to our hospital and 105 (age range 30-89 years, 58% female) were hospitalized at the Stroke Unit. Eighty-three percent had ischemic and 16% had hemorrhagic stroke. The most common etiologies were thrombosis in 41%, embolism in 36%, lacunar in 13%, arterial dissection in 5% and transient ischemic attack in 3%. Fifty eight percent of patients had partial anterior ischemic stroke (PACI), 73% had hypertension and 29.5% diabetes. Only 18% arrived to the Stroke Unit with less of 6 hours of evolution, 7% of patients were admitted within the 3 hours after the onset of symptoms and 18%, from 3 to 6 hours. The mean length of stay in the Stroke Unit was 6.6 days and at the hospital 9.9 days (p <0.01). The mean costs per patient at the Stroke Unit and at the hospital were US$ 5.550 and US$ 4.815, respectively (p =ns).
Conclusions:
The Stroke Unit decreases hospital stay days without raising costs importantly. The inclusion criteria for stroke patients admitted to the Unit were adequate and the stroke registry allowed a good assessment of the Unit operation.
