[Economic evaluation of the stroke units in Campania]

The Stroke Units (SU) delivers high quality care and treatment in patients affected by strokes. In Italy stroke is the second leading cause of death and the first of disability in adult people. There is significant evidence in literature indicating the better quality assistance SU provide in the treatment of neurological acute disease, with significant improvements in mortality and disability, when the therapeutic intervention (thrombolysis) is carried out within 3 hours after the onset of symptoms. Two are the aims of the present study: to evaluate the economic impact of both the start-up of Stroke Units in the Campania Region and the use of thrombolytic therapy for all treatable population. In the first case, the authors assume charges and costs on the national health service in absence of SU, rather than in the presence of these: the analysis compares the two alternatives to identify the most affordable one. Moreover, the authors try to estimate the potential savings achievable through the use of thrombolytic therapy: savings resulting from the difference between the number of cases treated in 2009 against the targeted population. By the results of the anticipate analysis, the global economic advantage for the Regional Banks is constituted by the sum of the savings hypothesized in two considered hypothesis. In the synthesis, the activation of SU and trombolytic treatment for all people whit eligibility criteria, may be considered health policy strategies extremely convenient for economic and social impact without causing high sacrifices for the Regional Banks.